Clostridium difficile (C. difficile)
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What is C. difficile?
Clostridium difficile (C. difficile) is a type of bacteria found in the environment, and in the feces (poop) of humans. Some people can carry the bacteria in their intestines without it causing them any harm. This is known as “colonization”. The bacteria can cause infection in others, known as “C. difficile infection (CDI)”, by producing a toxin that harms your intestines and causes symptoms.
What are the symptoms of CDI?
It is not certain exactly when you will start to feel sick. It can begin within 48 hours and up to 3 months after you have been exposed to the C. difficile bacteria. Symptoms can range from mild to severe and is different for each person. Symptoms may include:
- Watery diarrhea (loose poop, at least 3 times a day for 2 or more days)
- Abdominal pain or tenderness
- Loss of appetite
How is C. difficile spread?
C. difficile can be spread directly or indirectly from person to person through the “fecal-oral route” by:
- Putting anything in your mouth that has feces on it. This includes drinking and eating contaminated water and food.
- Touching your mouth after touching contaminated surfaces, such as toilets, doorknobs, or bedding, as the germ produces spores that can live on surfaces for long periods of time and are difficult to kill. Unclean hands can carry the germ from person to person.
CDI usually occurs in people who are taking antibiotics (i.e. medications that fight bacteria) in high doses or for a long time. Some antibiotics can kill the normal bacteria in the gut, allowing C. difficile to grow and cause symptoms.
CDI is a common cause of diarrhea in hospitals and other health care facilities because of the presence of the bacteria and the large number of people getting antibiotics. Healthcare workers can spread CDI to other patients by not cleaning their hands or equipment between patients.
How long is it contagious?
It is unknown how long CDI can be contagious, as it varies depending on the amount of toxin that is in the feces. Toxins or bacteria may stay in the feces for weeks. People who have illnesses or conditions that need antibiotic medication for a longer period of time and the elderly are at a greater risk of getting this disease.
How is CDI treated?
Treatment for people without symptoms is not recommended as it can make you sicker. If you or your child develops symptoms, see your health care provider.
- For mild symptoms, no additional treatment may be needed besides drinking plenty of fluids to stay hydrated and stopping the use of the antibiotics if possible.
- For more severe cases, your health care provider might prescribe medications, such as different antibiotics, or surgery to treat the infection. Make sure to take antibiotics as prescribed to kill all of the bacteria. Avoid medications that stop diarrhea as this can make things worse. New treatment options that are being explored include transplanting stool from a healthy person to the colon a person who has had repeated CDI infections (fecal transplantation) and use of probiotics.
How is CDI prevented?
Ways to prevent infection include:
- Wash your hands often for at least 15 seconds with warm water and soap, especially before and after preparing foods, before eating, before and after visiting a patient, and after handling diapers and using the washroom. Alcohol-based hand rub is less effective as it does not kill the spores.
- If you work in or visit a health care facility, follow precautions asked of you by the facility. Isolate patients who have C. difficile and have dedicated equipment for them. Gloves should be worn when caring for a patient with CDI or if in contact with his/her environment. Wash your hands properly before and after care. Properly clean and disinfect surfaces.
- Clean the house using an all-purpose household cleaner. Pay particular attention to areas that people touch often (i.e. “high touch” areas), such as door knobs and toilets. Follow the directions on the label, and wet and rub the surfaces well. Allow the surface to air dry.
For more information contact the Health Unit or speak to your health care provider.
- Ontario Ministry of Health and Long-Term Care – Clostridium Difficile
- Public Health Agency of Canada – Fact Sheet – Clostridium difficile (C. difficile)
- Public Health Ontario – Clostridium difficile infections (CDI)
- Heymann, D.L. (Ed.). (2015). Control of communicable diseases manual (20th ed.). Washington, DC: American Public Health Association.
- Ontario Agency for Health Protection and Promotion, Provincial Infectious Diseases Advisory Committee. (2013). Annex C – Testing, surveillance and management of Clostridium difficile. Annexed to: Routine Practices and Additional Precautions in All Health Care Settings. Toronto, ON: Queen’s Printer for Ontario.
- Ontario. Ministry of Health and Long-Term Care. (2015). Infectious diseases protocol, Appendix A: Disease-specific chapters, Chapter: Clostridium difficile infection (CDI) outbreaks in public hospitals. Toronto, ON: Queen’s Printer for Ontario.
- Public Health Agency of Canada. (2014). Fact sheet – Clostridium difficile (C. difficile). Retrieved from http://www.phac-aspc.gc.ca/id-mi/cdiff-eng.php.