Clostridium Difficile

If you have been diagnosed with Clostridium difficile, you are among 3 million Americans who suffer annually from the infection. C. difficile is a germ that causes diarrhea and other intestinal problems (Read about "Diarrhea"), according to the Centers for Disease Control and Prevention (CDC). While the infection is linked to roughly 14-thousand deaths annually in the United States, CDC says early detection and treatment can help reduce spreading the infection and can lead to a healthy recovery. Patients of hospitals, nursing home facilities and doctor's offices are especially vulnerable to C. difficile. While the infection can be treated, it is hard to detect. CDC says the number of hospital stays caused by C. difficile has tripled in the last ten years and remains one of the most concerning patient related safety threats today.

Causes

Patients on antibiotics are susceptible to C. difficile. (Read about "Antibiotics") When we take antibiotics to treat infections, the good germs that also protect against infection are destroyed for several months. This is when C. difficile moves into the body. The American Academy of Family Physicians, (AAFP) says spores from C. difficile can survive for a long time on contaminated surfaces. CDC says nursing home patients or those who have recently visited their doctor's office make up the largest percent of all C. difficile infections. Hospital patients account for about 25 percent of the infections. Community acquired C. difficile is a growing concern.

Symptoms

C. difficile infections are often difficult to track. According to CDC, most patients don't have any symptoms, but the bacteria shed in their stools. This can lead to the spread of the infection.

When symptoms do occur, they may involve the following:

• diarrhea (at least three bowel movements a day for two days or more)
• fever
• loss of appetite
• nausea
• abdominal tenderness and pain

Risk Factors

Anyone can become infected with C. difficile, but some people are at a higher risk. For example, CDC reports that almost half of the infections occur in people under the age of 65, but more than 90 percent of the deaths occur in the elderly. AAFP lists the following risk factors for C. difficile:

• men and women over the age of 65
• patients using antibiotics
• patients having recent surgical procedures
• patients sharing a hospital room with a C. difficile-infected patient
• unsupervised use of antibiotics
• use of antacids

Diagnosis

Diagnosing C. difficile requires a careful medical history, according to AAFP. Antibiotic use in the three months prior to symptoms is key in helping determine whether the germ is to blame for symptoms. Other information needed includes the following, according to AAFP:

• color, consistency and frequency of diarrhea
• history of fever
• recent surgical procedure
• previous infection with C. difficile
• abdominal symptoms
• change in bowel habits

Once the history is complete, there are several laboratory tests that can help diagnose C. difficile.

Treatment

C. difficile can clear up on its own when the patient simply stops using the antibiotics that may have originally allowed the infection to grow. Fluids and electrolytes are also part of the treatment to aid in rehydration. However, this is successful in only about one in four patients, according to CDC.

If the infection lingers, different antibiotics can be used for treatment.

AAFP suggests the following drugs, which have a very high success rate:

• metronidazole
• vancomycin

Treatment with these antibiotics typically lasts 10 days.

Treatment can also include what is called fecal transplantation. In this case, the gut bacteria from a healthy person are introduced into the gut of a person with C. difficile. This allows the good bacteria to crowd out the C. difficile.

Prevention

Patients can work to prevent the germ from spreading. Here are some suggestions from CDC:

• Wash hands after using the bathroom.
• Make sure a bathroom is cleaned well if someone with diarrhea has used it.
• Only take antibiotics as directed by your doctor.
• If you have been on antibiotics and get diarrhea several months later, make sure you report it to your doctor.

Related Information:

    Microorganisms