Clostridium Difficile

Clostridium difficile (also known as C. difficile) is a bacterium associated with diarrhea and intestinal inflammation among patients or residents in health care facilities. The disease is called Clostridium difficile-associated disease (CDAD). The elderly, patients taking antibiotics, or people who have serious health conditions (e.g. immune-compromised patients) may be at risk of contracting Clostridium difficile-associated disease.

Healthy people are usually not affected by Clostridium difficile. People who have other conditions and use antibiotics are at risk of developing Clostridium difficile diarrhea. The use of antibiotics can change the levels of good microorganisms found in the intestines. When there are fewer good microogranisms, Clostridium difficile can produce toxins that lead to an infection.

The symptoms of Clostridium difficile-associated disease include:

• watery diarrhea
• fever
• loss of appetite
• nausea
• abdominal pain and tenderness

In rare cases, Clostridium difficile can cause death. Commonly, the infection causes diarrhea, which can lead to complications such as dehydration.

Clostridium difficile is present in feces. It is spread from person to person through hand contact. Clostridium difficile may be transferred to patients via the hands of health care personnel who had contact with contaminated patients or their feces.

People can become infected if they touch objects or surfaces that are contaminated with feces and them touch their mouth.

Frequent hand washing (with soap and water) is an effective way to prevent the spread of the bacteria. In a hospital or care facility, routine practices may involve using alcohol-based hand rubs when hands are not visibly soiled, and soap and water if hands are visibly soiled.

Health care workers who care for symptomatic patients should use "contact precautions" in addition to routine practices, and follow infection prevention and control guidance as outlined by the Public Health Agency of Canada guidelines:

• Clostridium difficile Infection: Infection Prevention and Control Guidance for Management in Acute Care Settings
• Clostridium difficile Infection: Infection Prevention and Control Guidance for Management in Long-term Care Facilities

For example, the following precautions should be taken:

• Use alcohol-based hand sanitizers or wash hands frequently between patients and/or procedures.
• Use gloves during patient's care, as required.
• Dedicate equipment for use with that patient only, or cleaned and disinfected before use with another patient.
• Surfaces in the room should be cleaned regularly according to your organization’s infection control procedures. Pay particular attention to "high touch" areas (patient bathroom, light switches, hand rails, bedside tables, etc.).
• Continue these precautions until diarrhea has resolved or according to your provincial/territorial/organization's guidelines.