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What is a Clostridioides difficile Infection?
C.difficile (or C. diff as you may hear it called) is a spore-forming bacterium, which is present as one of the ‘normal’ bacteria in the gut of up to 3% of healthy adults.
C. difficile can cause illness when the balance of ‘normal’ bacteria in the gut is disturbed (commonly when antibiotics are being taken), and the bacteria are able to flourish. C. difficile produces a toxin that attacks the bowel lining.
What are the symptoms?
The effects of C. difficile can range from nothing, to diarrhoea of varying severity, and much more unusually to severe disease of the bowel. Diarrhoea commonly continues for 3 to 10 days.
Other symptoms can include fever, loss of appetite, nausea, and abdominal pain or tenderness.
How is C. difficile infection diagnosed?
Infection is usually diagnosed by carrying out laboratory testing, which shows the presence of C. difficile toxins in the patient’s faecal sample.
How can C. difficile be spread?
C. difficile bacteria and spores are spread by the faecal-oral route, meaning they pass out of the body via the faeces, and infect people via the oral route. Spores produced by the bacteria are very resistant and can remain in the environment for long periods of time if stringent cleaning is not carried out. Spores can be transported on the hands of people who have had direct contact with infected patients or with environmental surfaces contaminated with C. difficile.
Therefore, excellent hand hygiene and cleaning of the environment are the key to preventing spread of infection.
Who is at risk?
The risk of disease increases in patients with the following:
People over the age of 65; treatment with antibiotics; reduced immunity; gastrointestinal surgery or manipulation (such as repeated enemas); serious underlying illness; or long length of stay in healthcare settings.
How can it be treated?
C. difficile can be treated with specific antibiotics. If an antibiotic the patient is taking is thought to have caused the problem, it will usually be stopped or an alternative one prescribed. It is also important for patients with diarrhoea to have adequate fluid intake.
Most people with a C.difficile infection make a full recovery.
What can we do to prevent the spread of C. difficile?
Patients
If you are in hospital and experiencing diarrhoea with a suspected infectious cause, you will be nursed in a single room and you will also be allocated a toilet or a commode specifically for your use. This will help prevent the spread of infection to other patients.
Non-urgent investigations and assessments may be delayed while you are experiencing diarrhoea.
You must ensure you wash your hands with soap and water after using the toilet and before meals.
Laundry can be taken home and washed on a separate cycle, at the highest temperature that the fabric can withstand. Ensure hands are washed after handling soiled linen.
If you are experiencing diarrhoea at home, it is important to keep surfaces in bathrooms, kitchens and other areas clean.
Visitors
Visiting can still continue for patients with C. difficile, and visitors (as healthy people) are at very little risk of getting C. difficile whilst visiting.
Please report to the nurse in charge before visiting.
Please clean your hands before visiting and wash your hands with soap and water upon leaving the patient you are visiting.
Visitors are not required to wear gloves and aprons unless they are assisting with personal care of the patient.
Please do not visit if you are unwell (for example, if taking antibiotics, have diarrhoea and vomiting, heavy cold or chest infection).
Hospital
All members of staff must carry out good hand hygiene.
Disposable aprons and gloves must be worn when carrying out close personal care of patients, when contact with blood, body fluids or non-intact skin is likely.
Staff should ensure that the patient environment is clean and uncluttered, and that equipment is decontaminated after patient use.
What happens when I leave hospital?
Once you leave hospital you can carry on as normal provided your diarrhoea has settled. Once you have recovered, maintain good hand hygiene by washing your hands with soap and water after using the toilet and before meals or food preparation. If your diarrhoea re-starts, contact your GP and tell them that you have recently had a C.difficile infection. This will help to ensure that you are given the correct treatment if you need any.
Contact us
If you have any queries relating to this information, please contact the Infection prevention and control (IPC) service.
About this information
Service:
Infection prevention and control (IPC)
Reference:
LL/002
Approval date:
23 December 2024
Review date:
1 December 2027
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Important note
This page provides general information only. It is developed by clinical staff and is reviewed regularly every 3 years for accuracy. For personal advice about your health, or if you have any concerns, please speak to your doctor.