Clostridium difficile (klos-TRID-e-uhm dif-uh-SEEL), often called C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation of the colon. Illness from C. difficile most commonly affects older adults in hospitals or in long term care facilities and typically occurs after use of antibiotic medications.
In recent years, C. difficile infections have become more frequent, more severe and more difficult to treat. Each year, tens of thousands of people in the United States get sick from C. difficile, including some otherwise healthy people who aren't hospitalized or taking antibiotics.
Mild illness caused by C. difficile may get better if you stop taking antibiotics. Severe symptoms require treatment with a different antibiotic.
Some people who have C. difficile never become sick, though they can still spread the infection. C. difficile illness usually develops during or shortly after a course of antibiotics. But signs and symptoms may not appear for weeks or even months afterward.
The most common symptoms of mild to moderate C. difficile disease are:
In severe cases, C. difficile causes the colon to become inflamed (colitis) or to form patches of raw tissue that can bleed or produce pus (pseudomembranous colitis). Signs and symptoms of severe infection include:
When to see a doctor
C. difficile bacteria can be found throughout the environment — in soil, air, water, and human and animal feces. A small number of healthy people naturally carry the bacteria in their large intestine. But C. difficile is most common in hospitals and other health care facilities, where a much higher percentage of people carry the bacteria.
C. difficile bacteria are passed in feces and spread to food, surfaces and objects when people who are infected don't wash their hands thoroughly. The bacteria produce hardy spores that can persist in a room for weeks or months. If you touch a surface contaminated with C. difficile, you may then unknowingly ingest the bacteria.
People in good health don't usually get sick from C. difficile. Your intestines contain millions of bacteria, many of which help protect your body from infection. But when you take an antibiotic to treat an infection, the drug can destroy some of the normal, helpful bacteria as well as the bacteria causing the illness. Without enough healthy bacteria, C. difficile can quickly grow out of control. The antibiotics that most often lead to C. difficile infections include fluoroquinolones, cephalosporins, clindamycin and penicillins.
Once established, C. difficile can produce toxins that attack the lining of the intestine. The toxins destroy cells and produce patches (plaques) of inflammatory cells and decaying cellular debris inside the colon.
Emergence of new strain
Colon and rectum
The colon, also called the large intestine, is a long, tube-like organ in your abdomen. The colon carries waste to be expelled from the body. The rectum makes up the last several inches of the colon. ...
The majority of C. difficile cases occur in health care settings, where germs spread easily, antibiotic use is common and people are especially vulnerable to infection. In hospitals and nursing homes, C. difficile spreads mainly on hands from person to person, but also on cart handles, bedrails, bedside tables, toilets, sinks, stethoscopes, thermometers — even telephones and remote controls.
Although people — including children — with no known risk factors have gotten sick from C. difficile, your risk is greatest if you:
Complications of C. difficile infections include:
Tests and diagnosis
Doctors often suspect C. difficile in anyone with diarrhea who has taken antibiotics during the past two months or when diarrhea develops a few days after hospitalization. In such cases, you're likely to have one or more of the following tests:
Treatments and drugs
The first step in treating C. difficile is to stop taking the antibiotic that triggered the infection, when possible. For mild illness, this may be enough to relieve symptoms. But many people require further treatment.
Side effects of metronidazole and vancomycin include nausea and a bitter taste in your mouth. It's important not to drink alcohol when taking metronidazole.
Lifestyle and home remedies
Supportive treatment for diarrhea includes:
To help prevent the spread of C. difficile, hospitals and other health care facilities follow strict infection-control guidelines. If you have a friend or family member in a hospital or nursing home, don't be afraid to remind caregivers to follow the recommended precautions.
Preventive measures include:
Last Updated: 2010-11-03
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