Clostridium_Difficile

Clostridium difficile

What is Clostridium difficile?

C. difficile is short for Clostridium difficile - is a bacterium
that lives in the large bowel. A small number of adults have
C. difficile in their large bowel but it doesn't make them ill
because it's controlled by other types of bacteria. Most
babies and young children have C. difficile in their large
bowel, but it doesn't usually have a harmful effect. It's also
more commonly found in the elderly.

The bacterium can survive for long periods of time outside
the body by creating spores. These cells can resist
extremes of temperature and drying. They are only
destroyed by cleaning thoroughly with soap and water or
high level disinfectant.

What causes C. difficile?

If you have C. difficile infection, it's likely that you are taking
antibiotics for another illness. These medicines destroy the
bacteria which usually stop C. difficile from causing any
problems. You are more at risk if you are taking broad
spectrum antibiotics (antibiotics that can be used to treat a
wide range of conditions). These antibiotics can also
change the balance in your bowel, resulting in the
development of C. difficile diarrhoea.

C. difficile spores are found in the diarrhoea of people who
have C. difficile infection and can be passed on. This may
be through hand-to-hand contact with patients or healthcare
staff who come into contact with infected patients, and also
from contaminated objects such as bedpans, toilets or
surfaces.

C. difficile bacteria produce two toxins which damage the
cells that line your bowel. This means that the cells can't
function properly to absorb digested food and this leads to
diarrhoea.

The infection is much more common in older people - as
many as eight out of 10 people who develop it are over the
age of 65. You may also be at an increased risk if you have
had surgery to your digestive system or if you have a
condition that means your immune system isn't able to fight
infection as well as that of a healthy person.

What are the symptoms of C. difficile?

Your symptoms will vary depending on how seriously you are
infected. The main ones include:
• diarrhoea
• abdominal pain
• fever
• loss of appetite
• feeling sick

In some people C. difficile can cause inflammation and
bleeding in the large bowel. This is called
pseudomembranous colitis. Rarely, C. difficile may also
lead to your bowel perforating (tearing) and inflammation of
the inside of your abdomen (tummy). Sometimes C. difficile
infection can be fatal.

How is the infection treated?

If you have a mild C. difficile infection, the only treatment you
may need is to stop taking the antibiotics that are causing
the disruption of your bowel's usual bacteria. You are likely
to need treatment to replace the fluid that you will have lost
as a result of having diarrhoea. You may be able to take this
by mouth or you may need to have a drip put into a vein.

If you have a more serious infection, you will probably be
prescribed a different antibiotic such as metronidazole or
vancomycin. You will need to take this for at least 10 days.
Even if these antibiotics get rid of the infection, there is a
possibility that it will come back. This happens to about one
in five people who develop the infection. This is because C.
difficile spores are often resistant to treatment with
antibiotics and are difficult to destroy. You may be
prescribed the same antibiotic again or a different
treatment.

How can I keep from getting C. difficile?

If you are infected with C. difficile or have been in contact
with someone who has the infection, it's very important that
you take steps to avoid spreading the disease to anyone
else, particularly elderly people or others who may be at an
increased risk. You can do this by making sure you always
wash your hands with soap and water after going to the toilet
and before preparing food or eating. In addition, regularly
clean kitchens and bathrooms using a high level
disinfectant.

Are there any support organisations for people
affected by C. diff?

If you have been affected by C. difficile through having an
infection yourself, or if a friend or family member has been
infected, you can find help at the C.diff-Support website.