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Facts About...

CLOSTRIDIUM DIFFICILE


What is it?

Clostridium difficile is a bacteria that forms spores and may cause illness, particularly for people who are in hospitals and for residents of long-term care facilities. The bacteria are normally present in our intestines. Symptoms may develop when the bacteria outgrow the other bacteria that are usually present in the gut. The elderly and those who have used antibiotics for a long time are at increased risk of becoming ill.

How is it spread?

The bacteria are spread from person to person through direct contact with contaminated environments. Touching your mouth after first touching contaminated bedding, handrails, bedpans, sinks, taps, light switches, etc., can lead to infection. The environment becomes contaminated if hands are not carefully and thoroughly washed after going to the washroom, or if feces are inadequately cleaned up. The Clostridium difficile bacteria and its spores are very hardy and can be carried on the hands of health care workers as they move from patient to patient. The spore can survive in the environment for up to 70 days and prefers to live in dry, dusty areas.

What do I look for?

People in good health generally do not develop Clostridium difficile diarrhea. If symptoms develop, they usually include watery diarrhea, abdominal pain, fever, loss of appetite and nausea. For most people, the illness is mild and they recover on their own. Sometimes, particularly with the elderly, serious diarrhea can lead to dehydration. Uncommonly, the bacteria can cause the intestine to puncture, resulting in surgery.

Clostridium difficile is tested from a sample of feces. Only people who have symptoms should be tested. Those without symptoms or who have come in contact with someone with the disease do not need to be tested.

How is it treated?

Treatment is not recommended if there are no symptoms. In people with mild diarrhea, limiting antibiotics combined with ensuring adequate fluid intake is usually all that is required. With more severe symptoms, specific antibiotics may be required. Anti-diarrhea medicines should not be used since they can increase the severity of symptoms and lead to complications. Consult your physician for advice on what is best for you.

How can I protect myself?

  • Thorough hand washing is the best prevention. Wash hands thoroughly with soap and warm water before and after contact with an infected individual, after using the washroom, and prior to preparing, serving and eating food (Note: alcohol based hand sanitizers may not be effective against this microorganism).
  • Visitors to health care and long-term care facilities should wash their hands before and after visiting the facility.
  • Use gloves when caring for a person with Clostridium difficile associated diarrhea, especially if contact with feces is likely. Gloves should be discarded after each use and not saved for future reuse on the same person. Remember to wash hands immediately after removing gloves.
  • Immediately change and wash clothing that may have become contaminated with feces.
  • If possible, do not use the same washroom as an infected person. When sharing a washroom, do not share hand towels (single-use paper towels are preferable) and be sure to turn off the taps with a paper towel to prevent re-contamination of your hands.
  • Clean and disinfect hard surfaces in the washroom using a diluted household bleach solution (e.g., 1:10 solution of bleach which is 1 part bleach to 9 parts water).

More information can be obtained from

Durham Region Health Department, Environmental Help Line 905-723-3818 or 1-888-777-9613 or download the Provincial Infectious Disease Advisory Committee's Annex C: Testing, Surveillance and Management of Clostridium difficile In All Health Care Settings (PDF)

April 22, 2013