Here are some basic facts about Clostridium difficile (known as C diff).

• What is Clostridium difficile?
• How do you catch C diff?
• What are the symptoms of C diff?
• How is C diff diagnosed?
• Are some patients more likely to be made ill by C diff?
• Can C diff  be treated?
• Is it possible to get C diff more than once?
• How can C diff pass from one person to another?
• Is C diff just a problem in hospitals?
• What is the hospital doing to tackle C diff?
• What can patients and visitors do to help prevent C diff?

 

What is Clostridium difficile?

Clostridium difficile (C diff) is a bacteria that lives in the gut of around 1 in 30 healthy adults and children. When it multiplies C diff produces spores that are present in the faeces, can survive for a long time in the environment, and are resistant to ‘normal’ disinfectants. The normal bowel contains millions of different types of bacteria which help break down and digest our food. There are lots of these ‘good’ bacteria, but also some bacteria, such as C diff, which can cause ill-health. The ‘good’ bacteria usually help keep C diff in check.

How do you catch C diff

A few people carry C diff but remain in good health.  People can become infected with C diff if they touch items or surfaces (such as beds and equipment) that have been contaminated with C diff spores and then touch their mouths.

If the ‘good’ gut bacteria are not able to keep C diff in check, or if the body’s resistance to infection is lowered, C diff can multiply and produce spores and toxin. The toxin can cause inflammation of the bowel. This most often happens when people take antibiotics to treat other infections (the antibiotics kill off the ‘good’ gut bacteria), or if patients’ immunity is lowered by chronic or serious ill-health, surgery, or drugs.

What are the symptoms of C diff?

Bowel symptoms range from mild tummy upset to moderate loose stools to severe painful bloody diarrhoea.  Other symptoms include fever, loss of appetite, nausea and abdominal pain.

How is C diff diagnosed?

C diff is diagnosed by testing for C diff toxin in a stool sample or by examination of the bowel lining with a special camera (sigmoidoscopy).

Are some patients more likely to be made ill by C diff?

Elderly patients, patients who have received antibiotics, and those whose resistance is lowered by chronic or serious ill-health, surgery, or drugs are more likely to be made ill by C diff.

Can C diff be treated?

Mild illness usually responds well to stopping antibiotics and preventing dehydration by taking plenty of fluids.  In more severe illness anti-C diff antibiotics are added. Most patients will improve within a few days, and the diarrhoea symptoms typically resolve within two weeks. Anti-diarrhoea medication may make C diff diarrhoea worse, and is not recommended. 

Is it possible to get C diff more than once?

C diff infection usually responds well to treatment, but approximately 20% of patients will experience recurrence of diarrhoea symptoms up to several weeks after treatment has finished. A further course of anti-C diff antibiotics will be effective in almost all patients, and other specialist treatments are available.

If your diarrhoea returns after treatment for C diff infection it is important to restart treatment promptly. If you have been discharged home you should visit your GP as soon as possible, taking a stool sample with you.(Sample containers can be obtained from your GP if you have not already got one).

How can C diff pass from one person to another?

C diff is spread on hands person-to-person, or environmental surface-to-person. It is always important to wash your hands after using the toilet and before handling food or eating and drinking. In hospitals staff, patients, relatives, and other visitors must all be thorough in their hand-washing with soap and water every time they deliver treatment or visit. Alcohol gel alone is not effective against C diff - soap and water must be used.

Is C diff just a problem in hospitals?

People who have had antibiotics or have lowered immunity can develop C diff illness without any contact with hospital. These community-acquired cases account for approximately 25% of the total.

What is the hospital doing to tackle C diff?

The prevention of hospital infections is the top clinical priority for the Trust. At NUH we do everything we can to prevent C Diff. We are:

• ensuring staff routinely wash their hands with soap and water before and after touching every patient
• training all staff in the correct way to wash hands and to clean equipment to prevent cross-infection
• monitoring and improving cleanliness in all wards and departments
• minimising the risk of cross-infection by quickly isolating patients with suspected or proven C diff in a single room or in a separate bay
• using a new (2007) isolation ward on the Queen’s Medical Centre campus
• using hydrogen peroxide, which kills C diff spores, to support other deep cleaning on the wards
• making sure antibiotics are used correctly and prescribed only when absolutely necessary and for the shortest possible time.

What can patients and visitors do to help prevent C diff?

Wash hands carefully and every time with soap and water

Remind staff to wash their hands when they may have forgotten