Clostridium Difficile

What is Clostridium difficile?

Clostridium difficile (also known as C. diff) is an organism that lives in the gut. The human gut contains many millions of bacteria, which are beneficial to us, helping digest our food. If a person is given antibiotics to treat an infection, the antibiotics may also kill the 'normal flora' or 'good bacteria' in the gut. This can sometimes allow other bacteria like Clostridium difficile to take over and cause illness. Although this can be a risk, it is still very important to take the antibiotics prescribed by your doctor, in order to treat your infection.

How the Trust is working towards reducing Clostridium difficile:

  • The Trust has a strict antibiotic policy, which is frequently monitored, to ensure that our patients are given appropriate antibiotic treatment during their time in hospital.
  • Hand hygiene remains a priority for our staff and the Trust carries out hand hygiene auditing on a monthly basis (this is carried out more frequently if compliance scores should slip).
  • The Trust frequently monitors the cleanliness of the environment and equipment.
  • The Infection Prevention & Control Team (IPCT) regularly monitor Trust isolation procedures to ensure that patients with symptoms of diarrhoea are isolated promptly.
  • The IPCT teach all staff on an annual basis about infection control and this includes a section on Clostridium difficile.

What causes it?
Clostridium difficile is a bacteria which produces a toxin (poison), which can cause changes in the gut. This is referred to as CDT (Clostridium difficile toxin), or CDAD (Clostridium difficile associated diarrhoea) or CDD (Clostridium difficile disease). The illness usually presents as diarrhoea, though there are other rarer side effects. It is usually associated with the use of antibiotics prescribed to treat other conditions or given as a precaution. Other mechanisms that alter the 'normal flora' of the gut can also lead to development of Clostridium difficile disease (e.g. surgery or chemotherapy).

How is it spread?
The organism produces hardy spores, that can survive for long periods of time in the environment. They are generally resistant to disinfectants. When a patient has Clostridium difficile the environment becomes contaminated with the spores. It is then possible for the spores to be passed on to other patients via healthcare workers’ hands or the environment. It is possible for patients to become carriers of the organism. However if the patient is asymptomatic (e.g. has no diarrhoea) they are not an infection risk to others. Treatment of asymptomatic carriers is unnecessary. Once Clostridium difficile diarrhoea has started, the patient is a likely infection risk to others. However, as soon as the diarrhoea has stopped and the patient has a normal stool they are no longer an infection risk. Soap and water must be used for cleaning hands as the foam hand sanitiser is not effective against Clostridium difficile.

How do I know I've got it?
Clostridium difficile infection is often diagnosed clinically by the presence of frequent, watery, explosive diarrhoea often accompanied by abdominal pain. If suspected, a stool specimen will be sent to the laboratory for confirmation.

Can it be treated?
Although Clostridium difficile is often caused by antibiotics, it is also treated using antibiotics. In some cases it may be enough to just stop the causative antibiotics, though your doctor would make this decision.

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