C. diff (Clostridioides difficile) Infection

Overview

What is Clostridioides difficile?

Clostridioides difficile (pronounced klos-TRID-e-OY-dees dif-uh-SEEL), also known as C. diff. or C. difficile), is a germ that can cause diarrhea or a more serious intestinal condition such as colitis.

Symptoms and Causes

What causes Clostridioides difficile?

When a person takes antibiotics, the “good germs” in the intestines are killed off making it easier to become infected by the Clostridioides difficile germ. The germ is found in stool (bowel movement), and is spread to other people by unwashed hands, contaminated surfaces, or objects.

In a healthcare setting, the germs have been found on objects such as toilets, bathroom fixtures, bed rails, and rectal thermometers. The germ is able to survive for a very long time on a variety of surfaces.

What are the symptoms of Clostridioides difficile?

Symptoms may include:

  • Watery diarrhea
  • Fever
  • Loss of appetite
  • Nausea or vomiting
  • Stomach (belly) pain or tenderness

Diagnosis and Tests

How is Clostridioides difficile infection diagnosed?

Clostridioides difficile is diagnosed by testing the stool of patients who are having frequent liquid diarrhea such as 3 or more stools in a 24 hour period. In a severe case, a procedure called flexible sigmoidoscopy may be performed to confirm that the lower part of the intestine (colon) is inflamed. In this procedure a long, thin tube called a sigmoidoscope is placed inside the intestine to allow a doctor to visually examine the colon.

Management and Treatment

How is Clostridioides difficile infection treated?

Clostridioides difficile is usually treated with antibiotics prescribed by your healthcare provider. In rare severe cases, a person might need to have surgery to remove the infected part of the intestine. Patients who have Clostridioides difficile infection should not use drugs to control diarrhea unless prescribed by their healthcare provider as this could make the infection worse.

Prevention

Clostridium difficile: Infection Prevention and Contact Precautions

What can be done to prevent Clostridioides difficile infection?

To prevent Clostridioides difficile infection, hospitals and nursing homes take the following precautions:

  • Ask the patient to clean their hands after using the bathroom.
  • Make sure all healthcare providers clean their hands before and after caring for every patient.
  • Use a disinfectant to clean rooms and equipment.
  • Give patients antibiotics only when necessary.
  • Alert any facility to which a Clostridioides difficile patient may be transferred.

When caring for patients with Clostridioides difficile hospitals and nursing homes will:

  • Place patients with Clostridioides difficile infection in a private room whenever possible.
  • Place the patient in Contact Precautions, also known as isolation. Healthcare providers wear gloves and a gown over their clothing when entering the room and wash their hands with soap and water when leaving the room.
  • Have patients with Clostridioides difficile infection remain in their room unless they need to leave for medically necessary treatments or therapies.
  • Ask visitors, or anyone entering the room, to clean their hands when they come in and before they leave the room.

Hospitals and nursing homes may also ask the patient’s visitors to:

  • Wear gloves and a gown especially if they are helping to provide care.
  • Not eat or drink in the patient’s room.
  • Not use the patient’s bathroom.

What do I do after returning home from the hospital?

You can return to your normal routine once you are back at home. The diarrhea is often better or gone before you go home, which makes the spread of Clostridioides difficile to others much less likely.

You can lower the chances of developing Clostridioides difficile infection again or spreading it to others. For example:

  • Take your medication to treat Clostridioides difficile exactly as instructed by your healthcare provider and pharmacist. Take all the medication as directed. Do not take half-doses or stop before you have taken all the medicine.
  • You and your family members should wash their hands after going to the bathroom, before preparing or eating food, and when hands are dirty.
  • Clean surfaces in bathrooms and kitchens regularly with household detergents/disinfectants.
  • Tell your healthcare provider if your diarrhea returns.

Outlook / Prognosis

What happens after treatment for Clostridioides difficile infection?

Antibiotics for Clostridioides difficile are usually an effective treatment. Fever usually goes away within 2 days, and diarrhea ends in 2 to 4 days.

In about 10-20% of patients, symptoms may recur (return) within 1 to 2 weeks of ending treatment. Tell your healthcare provider if your diarrhea returns.

Last reviewed by a Cleveland Clinic medical professional on 04/24/2019.

References

  • Centers for Disease Control and Prevention. . Accessed 4/24/2019.Clostriodes difficile infection (http://www.cdc.gov/hai/organisms/cdiff/Cdiff-patient.html)
  • American College of Gastroenterology. . Accessed 4/24/2019.Guidelines for Diagnosis, Treatment and Prevention of Clostridium difficile Infections (http://gi.org/guideline/diagnosis-and-management-of-c-difficile-associated-diarrhea-and-colitis/)
  • The Merck Manual for Health Care Professionals. . Accessed 4/24/2019.Clostridium difficile-Induced Diarrhea (https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/clostridioides-formerly-clostridium-difficile-induced-diarrhea?query=Clostridioides%20difficile)

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