C. difficile

C. difficile is one of the many types of bacteria that can be found in feces (bowel movement), and has been a known cause of health care-associated diarrhea for about 30 years.

C. difficile is not new. Although people may lately associate it with health care settings, it doesn’t come from hospitals, long-term care homes or laboratories. It is widely distributed in the environment and can be found in the human intestine, occurring naturally in 3-5% of adults (more commonly in the elderly) without causing symptoms.

C. difficile can be picked up on the hands from exposure in the environment and can get into the stomach once the mouth is touched, or if food is handled and then swallowed. Once in the stomach, the bacteria usually will not cause any problems unless the other bowel bacteria are disturbed, which can happen when antibiotics are taken. The use of antibiotics increases the chances of developing C. difficile diarrhea as it alters the normal level of good bacteria found in the intestines and colon. Without the presence of the normal bowel bacteria, the C. difficile bacteria may start to grow and produce a toxin that can damage the bowel and lead to watery diarrhea, fever and abdominal pain or tenderness.

A sample of liquid stool is collected when it is occurring frequently and is not normal for the patient. This sample will be sent to the lab for the appropriate testing.

Treatment depends on how sick you are. People with mild symptoms may not need treatment. For more severe disease, antibiotics are required. If you are in the hospital and have C. difficile diarrhea, you will be put on precautions until you are free from diarrhea for at least two days. Your activities outside the room may be restricted. All health care staff, family and visitors who enter your room will wear a gown and gloves. Everyone MUST clean their hands upon entering and when leaving your room.

When a person has C. difficile, the bacteria in their feces can contaminate surfaces such as toilets, bedpans, commode chairs, and door handles (if feces is on hands). Other healthy individuals can contaminate their hands if they touch these items. If these individuals then touch their mouths without washing their hands, they can become infected. C. difficile produces spores that survive for long periods and are resistant to destruction by many environmental factors (e.g. temperature, humidity).

Hand hygiene: everyone’s responsibility

Good hand washing by everyone, healthcare staff, physicians, volunteers, patients and visitors, is the single most effective way to prevent the spread of infectious diseases like C. difficile. In addition to staff following standards as identified within our internal C. difficile procedure and it is very important that we prompt or ‘cue’ each other in order to remind ourselves to use personal protective equipment (PPE) and perform hand hygiene.