Clostridium Difficile Infection

What is a Clostridium difficile infection?

Clostridium difficile infection, or C. difficile, is an infection in your colon caused by bacteria. Different types of bacteria live inside the colon, creating a healthy balance between good and bad bacteria. If the C. difficile bacteria grow rapidly, this can disrupt the healthy balance of the colon. This can cause the lining of the colon to swell, which leads to an infection.

How does a Clostridium difficile infection spread?

The bowel movement of a person with a C. difficile infection contains C. difficile bacteria. Infected people who do not wash their hands after having a bowel movement can spread the infection. C. difficile bacteria may also be on surfaces, such as the tops of tables. The bacteria are often spread in a healthcare setting, such as a hospital.

What increases my risk for a Clostridium difficile infection?

  • Antibiotics: Antibiotic medicine kills both good and bad bacteria, which may upset the normal balance of bacteria in the colon. Your risk of getting C. difficile infection increases the longer you take antibiotic medicine. Your risk also increases if you take more than 1 type of antibiotic.

  • Hospital stay: A long hospital stay, or sharing a room with a C. difficile-infected patient, increases your risk.

  • Age: Older adults may get infections more easily than younger people because of body changes that occur with age.

  • Medical conditions: A weak immune system caused by medicines, such as chemotherapy or steroids, can increase your risk for C. difficile. Major surgery, such as an organ transplant, can weaken your immune system. Your risk is increased if you have inflammatory bowel disease.

  • Dormant infection: Inactive C. difficile bacteria may be in your body from a previous infection. This bacteria can cause a new infection.

  • Antacids: Antacid medicine decreases stomach acid. Stomach acid normally works to kill harmful bacteria. This can upset the balance of bacteria in your colon and increase your risk of C. difficile infection.

What are the signs and symptoms of a Clostridium difficile infection?

Diarrhea is the most common symptom of C. difficile infection. You may have bad-smelling diarrhea many times a day. You may see blood, mucus, or pus in your bowel movements. You may also have any of the following:

  • Fever or cramping pain in your abdomen

  • Nausea or vomiting

  • Dehydration (loss of too much body fluid)

How is a Clostridium difficile infection diagnosed?

  • Bowel movement tests: A sample of your bowel movement is sent to a lab for testing. This test may show what kind of bacteria is causing your illness, and helps caregivers know what treatment is best for you.

  • Blood tests: Blood tests can show signs of an infection. The blood may be taken from a blood vessel in your hand, arm, or the bend in your elbow.

  • Colonoscopy or sigmoidoscopy: A scope is a long, bendable tube with a light on the end. The scope may also have a camera on it. During a colonoscopy or sigmoidoscopy, the scope is put into your anus and moved forward into your large colon. Caregivers look for problems, take pictures, and collect samples that are sent to the lab for tests.

  • CT scan: An x-ray machine uses a computer to take pictures of your colon. Before taking the pictures, you may be given dye through an IV. The dye helps your colon show up better in the pictures. People who are allergic to shellfish (lobster, crab, or shrimp) may be allergic to this dye. Tell your caregiver if you are allergic to any of these.

How is a Clostridium difficile infection treated?

The goal of treatment is to restore the healthy balance of bacteria to your colon. This should help stop your diarrhea. You may need the following:

  • Antibiotics: Antibiotics help treat or prevent an infection caused by bacteria. If antibiotics caused your C. difficile infection, you may need to stop taking them and switch to a different antibiotic. Ask your caregiver for more information.

  • Oral rehydration therapy: You will need to drink plenty of liquids to avoid dehydration. You may also drink an oral rehydration solution (ORS). An ORS has the right amounts of water, salts, and sugar needed to replace body fluids. Ask your caregiver where to buy ORS and how much to drink.

  • Immune globulin medicine: You may need this to help your immune system if you have a severe C. difficile infection.

  • Surgery: If your C. difficile infection is severe or has damaged your colon, you may need surgery called colectomy. During surgery, part of your colon is removed.

What are the risks of a Clostridium difficile infection?

  • You are at risk of dehydration if diarrhea and vomiting causes you to lose too much fluid. Fluid loss can also decrease or increase the amount of electrolytes in your body. This can cause seizures or problems with how your heart works. Your blood pressure may drop too low and you may faint. These problems can be life-threatening. Medicine used to treat C. difficile infection may cause vomiting, mouth irritation, or skin rashes. The medicine may not kill your C. difficile bacteria. Even after being treated for C. difficile infection, there is a risk, especially among older adults, of getting the infection again.

  • Without treatment, C. difficile can lead to sepsis (blood infection), or an enlarged colon. Your colon may get damaged, or your kidneys may stop working. The risk of serious or life-threatening problems from C. difficile infection is greater if you already have other medical problems.

How can I manage my Clostridium difficile infection?

  • Wash your hands: Wash your hands often with germ-killing soap and warm, running water. Alcohol-based hand rubs do not kill C. difficile bacteria. Always wash your hands well after you use the toilet, diaper a child, and before you prepare or serve food. Tell anyone who touches you to wear gloves and wash their hands.

  • Clean surfaces with bleach: Clean tabletops, desks, and other surfaces before anyone else touches or uses them. Clean with chlorine-based disinfectants, such as household bleach.

  • Avoid the spread of C. difficile: Do not share any items with other people. Use as many disposable items, such as paper plates, as you can. Do this until your diarrhea has gone away.

When should I contact my caregiver?

Contact your caregiver if:

  • You have a fever.

  • Your diarrhea is getting worse.

  • Your signs and symptoms get worse.

  • Your signs and symptoms do not go away, or they come back, even after treatment.

  • You cannot eat or drink.

  • You have questions or concerns about your condition or care.

When should I seek immediate help?

Seek immediate help or call 911 if:

  • You have a fever and stomach cramps that get worse, or do not go away.

  • Your abdomen is hard or feels swollen.

  • You have black or bright red stools.

  • You vomit blood.

  • You are short of breath, or feel like you are going to faint.

  • You have 1 or more of the following signs of dehydration:

    • Dizziness or weakness, or extreme sleepiness.

    • Dry mouth, cracked lips, or you feel very thirsty

    • Fast heartbeat or rapid breathing

    • Very little urine or no urine

    • Sunken eyes

    • A child may be more irritable or fussy than usual. The soft spot on a baby's head may look sunken in.

Care Agreement

You have the right to help plan your care. Learn about your health condition and how it may be treated. Discuss treatment options with your caregivers to decide what care you want to receive. You always have the right to refuse treatment. The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

© 2013 Truven Health Analytics Inc. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes. All illustrations and images included in CareNotes® are the copyrighted property of A.D.A.M., Inc. or Truven Health Analytics.

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