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About Us - Our Performance - Clostridium difficile (C. difficile) - Overview



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What is C. difficile?

Clostridium difficile (also known as C. difficile or C. diff) is a type of bacteria that is found in the intestinal tracts. The C. difficile bacteria produce a toxin that can cause inflammation. The affected person may experience diarrhea and other serious intestinal conditions. It usually does not cause illness except under certain circumstances.

 

What causes C. difficile?
Our bowels contain many different bacteria, both good bacteria that don’t cause infection, and bad bacteria, that can cause infection. The presence of good bacteria help to keep disease-causing bad bacteria, like C. difficile, in check. 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. With disruption of the good bacteria, the C. difficile bacteria may start to grow and multiply and produce a toxin that can damage the walls of our bowel.

 

In addition to antibiotics, certain medications and health conditions can make a person more susceptible to diseases caused by bad bacteria like C. difficile. These include:

  • gastro-intestinal surgery/manipulation,
  • certain stomach medications,
  • a long stay in a healthcare setting,
  • a serious underlying illness,
  • a weakened immune system, or
  • advanced age.

How does someone get the C. difficile bacteria?
C. difficile can be picked up on the hands and can get into the stomach once the mouth is touched, or if food is handled and then swallowed.

 

How does C. difficile spread?
When a person has C. difficile, the bacteria in their feces can get on surfaces such as toilets, bedpans, commode chairs, and door handles.  If healthy individuals then touch their mouths without washing their hands, they can become infected. C. difficile produces spores that survive for long periods especially in warm, moist places.  It is a very hardy bacteria which can live for many months and even years in the environment.

 

How can I tell if I have C. difficile?
The toxin produced by the C. difficile bacteria causes the intestines to swell.  If you develop C. difficile-associated disease, the usual symptoms are watery diarrhea, fever, loss of appetite, nausea, abdominal pain or tenderness. The diarrhea may appear less than a week after getting C. difficile, or not until the person starts taking antibiotics. It is estimated that 3-5% of people carry this bacteria without getting sick – in hospitals and long-term care homes that number may be higher.

 

How can I protect myself from C. difficile?
Hand hygiene is your best protection against C. difficile. Good handwashing by everyone, including healthcare staff, physicians, volunteers, patients and visitors, is the single, most effective way to prevent the spread of infectious diseases like C. difficile.

 

How is C. difficile treated?
For some people who are not in the hospital, they may have mild symptoms which will get better without treatment after they finish the antibiotics that caused the symptoms. In more severe cases, and for patients already ill and in the hospital C. difficile-associated diarrhea is treated with an antibiotic that is active against this bacteria. Sometimes medications that help to restore the normal balance of good and bad bacteria are used as well. The symptoms will usually go away within a few days. However, C. difficile-associated diarrhea is a serious illness that can be difficult to treat. Up to 30% of patients treated for this disease will have a recurrence of the infection within the first 2 months of treatment. In some cases the damage to the intestines is severe, and surgery may be needed.

 

What happens when patients have C. difficile?
When patients are diagnosed with the C. difficile-associated disease, they are placed on contact precautions. People coming into the room must wear isolation gowns and gloves and clean their hands upon leaving the room. This is to protect visitors, staff and other patients. The patients are placed in single rooms while they complete their treatment. Contact precautions are discontinued when the diarrhea has cleared up.

 

Information for Patients and Visitors

 

Can people with C. difficile have visitors?
Yes. Restrictions on activities or visitors at home or in the community are not necessary.
If you are visiting a person with diarrhea in a hospital or a long-term care home you will have to follow contact precautions required by that facility.  If you are visiting someone and they need to go to the bathroom or have their diaper changed do not assist with this activity.  Ask nursing staff to help the patient. It is very important to perform hand hygiene after visiting these facilities. Wash your hands or use a hand sanitizer if hands are not visibly soiled.

 

More patient-specific information is available at www.ontario.ca/patientsafety and www.oha.com/patientsafetytips, and www.oha.com/cleanhandsprotectlives.

 

If you have any questions about our hospital’s infection prevention and control program, please contact Mackenzie Health Infection Prevention and Control Department at ipac@mackenziehealth.ca.

Mackenzie Health / 10 Trench St. Richmond Hill, On. L4C 4Z3 / Richmond Hill Line: 905-883-1212 or Vaughan Line: 905-832-4554 / TTY Service: 905-883-2123