What is Clostridium Difficile (C. difficile)?

C. difficile is a bacteria that:

• can be part of the normal bacteria in the large intestine
• is one of the many bacteria that can be found in stool (a bowel movement)

Infection occurs when good bacteria in the bowel are reduced or eliminated, allowing C. difficile to grow and produce toxins. This toxin can damage the bowel and cause diarrhea.

C. difficile is one example of a hospital-acquired infection and is one of the most common infections found in hospitals and long-term care facilities. It has been a known cause of healthcare-associated diarrhea for about 30 years.

Who is at risk for C. difficile?

People with illnesses or conditions treated by antibiotics may be more susceptible to C. difficile. This is because antibiotics can change the normal balance of bacteria in your large intestine, making it easier for C. difficile to grow.

Old age and the presence of other serious illnesses may also increase the risk of C. difficile disease.

What are the symptoms of C. difficile?

Symptoms are usually mild but can be severe. The primary symptoms are watery diarrhea, fever and abdominal pain or tenderness. In some cases, you may not have diarrhea. Blood may or may not be present in your stool.

How does C. difficile spread?

When someone has C. difficile, the germs in their stool can soil surfaces such as toilets, handles, bedpans or commode chairs. If you touch these items, your hands can become soiled. If you then touch your mouth, you can swallow the germ. Your soiled hands can spread germs that can survive for a long time on other surfaces if not properly cleaned.

To prevent the spread of infectious diseases like C. difficile, we:

• wash hands thoroughly and often
• thoroughly clean surfaces

How is C. difficile diagnosed?

If a C. difficile infection is suspected, you will be asked to give a stool (feces) specimen that will be tested for bacteria and/or its toxins.

How is C. difficile treated?

Treatment depends on how sick you are. As soon as the antibiotics that caused the symptoms are no longer taken, mild diarrhea will stop. However, your physician will guide treatment, and you may be given different antibiotics to treat the infection.

What precautions are used to prevent the spread of C. difficile in the hospital?

If you are in the hospital and have C. difficile diarrhea:

• you will be isolated until you are free from diarrhea for at least two days and your activities outside your room will be restricted.
• All health care staff who enter your room will wear a gown and gloves.
• Everyone must clean their hands when entering and leaving your room.
• A commode may be left in your room specifically for your use.

Your health care team will advise you if other precautions are required.

How can I help prevent the spread?

We all have an important role to play in preventing the spread of C. difficile. It is most important to pay attention to good hand washing and follow the instructions of your health care team. You must wash hands:

• after using the toilet or bedpan
• before eating
• each time you leave your room

Please don't be shy about reminding everyone to wash their hands. Note that staff and visitors may also be required to wear a gown and gloves while in your room.

Why are special precautions needed?

Precautions are needed because surfaces that hands touch can become contaminated with bacteria. The bacteria can survive on surfaces for a long time if they are not properly cleaned. To prevent the spread to other patients in the hospital, everyone must follow these precautions.

Can I give C. difficile to my family or friends?

Healthy people who are not taking antibiotics are at a shallow risk of getting this organism. Their best protection against even a small risk is to wash their hands after visiting you and follow the above precautions. Other patients in the hospital are at greater risk of getting C. difficile infection. C. difficile spores can survive on surfaces for weeks. Therefore, the single best defence against C. difficile is frequent and thorough handwashing.