Below are some of the most frequently asked questions about the contraction of C-diff infection.
Yes. C-diff or Clostridium difficile is shed in feces. Any surface, device, or material (e.g., commodes, bathing tubs, and rectal thermometers) that becomes contaminated with feces may serve as a reservoir for the C-diff spores. The infection is usually spread hand to mouth.
Symptoms include watery diarrhea, fever, loss of appetite, nausea, belly pain and tenderness.
C-diff infections are the result of a perfect storm between poor hygiene, overuse of antibiotics and an aging population. By washing your hands with soap you can safeguard transferring fecal matter containing C-diff spores from hand to mouth. Any surface, object or material that becomes contaminated with feces can become a reservoir for the C-diff spores.
Because the C-diff bacteria can be contained in human feces, washing your hands after using the bathroom is one of the most effective ways to halt the spread of C-diff. Always use soap and water, rinse those spores down the drain. Hand gel is not enough!
Yes. Alcohol-based hand sanitizers are a great way to fight many kinds of germs. Continue to use it, particularly during the cold and flu season. However, hand gel is ineffective in preventing the spread of C-diff infection. Use soap and water after each time you go to the bathroom; rinse those spores down the drain. Hand sanitizer is not a substitute for soap.
Anyone can contract C-diff infection. However, the elderly and people with certain medical problems have the greatest chance of contracting severe C-diff infections. Those who have been taking antibiotics are also at higher risk for contracting the illness.
Individuals on antibiotics are more likely to succumb to a C-diff infection. Antibiotics kill the normal intestinal flora (normal gut bugs) that serve as protection against C-diff infection. It is estimated that 50 percent of prescribed antibiotics are totally unnecessary and can do you more harm than good. If you or a loved one is showing C-diff signs and symptoms, talk to your health care provider. He or she may stop or change your antibiotics, and test your watery stool for C-diff. In many cases this will clear up your signs and symptoms without further treatment. Always ask your physician if the antibiotics they prescribe are absolutely necessary, and don’t pressure your provider for antibiotics if he or she does not prescribe them.
Yes. Your doctor can prescribe the proper antibiotic treatment for a C-diff infection. In about 20 percent of patients, the infection will resolve within 2 to 3 days of discontinuing the antibiotic to which the patient was previously exposed. Antibiotic therapy with metronidazole, vancomycin (administered orally), or recently approved fidaxomicin is effective in treating C-diff infection. In some severe cases, a person might have to have surgery to remove the infected part of the intestines. This surgery is needed in only 1 or 2 out of every 100 persons with C-diff.
C-diff infections can be serious and have been linked to the deaths of 20,000 Americans every year. The majority of cases resolved themselves without serious consequences.
If your doctor suspects you have a C-diff infection, he/she can order testing on unformed stool (those specimens that take the shape of the container). The lab should be able to run a test for toxin A and B, and many can perform Polymerase Chain Reaction (PCR) test to confirm your diagnosis. PCR testing is expensive when compared to C-diff toxin testing, but when it’s available provides a higher sensitivity than the standard toxin testing.
The “gold standard” for identifying toxinogenic Clostridium difficile is the cell cytotoxicity test. A laboratory cell line is exposed to toxin B in fecal eluate. C-diff is confirmed when an antitoxin reverses the effects of the toxin on the cells. Alternatively, C-diff can be cultured and then tested for the presence of toxins. These methods are too slow to be of use in clinical decisions.
For those suffering with recurring bouts of C-diff there is a treatment known as the Fecal Microbiota Transplant (FMT). This emerging treatment has been reported to offer a better than 90 percent* success rate. FMT therapy involves infusing healthy family donor stools in people with C-diff infections.
*Source: Patient Safety Summit, 2014
Yes. Any surface, device, or material––such as toilets or rectal thermometers–– that becomes contaminated with feces can become a reservoir for the C-diff spores. It is recommended that you bleach bathrooms and all contact areas where a C-diff sufferer spends time. Make sure everyone in the household regularly washes their hands with soap after using the restroom, bathing a patient/loved one, helping anyone to or from the bathroom, or changing a diaper. It is recommended that you bleach bathrooms for the duration of a family member’s diarrhea. If possible, have one bathroom dedicated for their use.
If you are a doctor, restrict what antibiotics you prescribe. It is estimated that approximately 50% of all antibiotics given out are not even needed. This practice unnecessarily raises the risk of C-diff infections. When possible, avoid such antibiotics as clindamycin, cephalosporins, monobactams, carbapenems, and floroquinolones.
Here is a list of protocols that can help hospitals lower the incidence of HAIs like C-diff:
• Wash your hands thoroughly with soap and water after using the restroom and before eating
• When working with C-diff patients use gloves and gowns when entering the room and during patient care
• Report any patient experiencing diarrhea
• Reassess antibiotic use when someone displays C-diff symptoms
• Clean room surfaces with bleach or another EPA-approved, spore-killing disinfectant daily and after a patient with C-diff has been treated there
• When a patient transfers, notify the new facility if the patient has a C-diff infection
• Use gloves and gowns when working around a suspected C-diff sufferer
• Use contact precautions for duration of diarrhea
• Suggest testing to the attending physician
• Clean and disinfect all equipment
• Place these patients in private rooms or with other patients with C-diff