Clostridium difficile infection

This factsheet is for people who have Clostridium difficile (C. difficile) infection, or who would like information about it.

C. difficile is a type of bacteria that doesn't usually cause problems in healthy people. The infection mostly affects older people, particularly those who are unwell or in hospital.

About Clostridium difficile infection

Most children and about three in 100 adults have C. difficile in their bowel. This doesn’t usually cause any problems in healthy people because the growth of C. difficile is controlled by other types of bacteria. However, some antibiotics destroy the bacteria that usually prevent C. difficile from multiplying. If this happens, the number of C. difficile in your bowel can increase and cause symptoms of the infection.

C. difficile infection that causes symptoms is much more common in older people – mostly those who are over 65. People in hospital are particularly vulnerable to C. difficile infection because they are already unwell and may also be taking antibiotics.

The infection can spread from person to person via C. difficile spores, which are tiny parts of the bacteria that are able to reproduce. They can survive for long periods of time outside your body, for example on surfaces and clothes. The spores can only be destroyed by thorough cleaning with soap and water or disinfectant – alcohol gels aren’t as effective.

Symptoms of Clostridium difficile infection

The symptoms of C.difficile infection can include:

• diarrhoea
• abdominal (tummy) pain
• blood in your faeces
• a high temperature
• loss of appetite
• feeling sick

The symptoms of C.difficle infection can last for a couple of days to a few weeks.

These symptoms may be caused by problems other than C.difficile infection but if you have them, and have recently been treated with antibiotics (especially older adults) you should see your GP.

Complications of Clostridium difficile infection

Sometimes, C. difficile infection can cause inflammation (colitis) of your bowel. If this is severe, you can be at risk of developing a life threatening condition known as pseudomembranous colitis. Rarely, a C. difficile infection can lead to your bowel perforating (tearing) and blood poisoning, which can be fatal.

Causes of Clostridium difficile infection

C. difficile infection is usually caused by taking antibiotics for another illness. You're more at risk of getting C. difficile infection if you're taking broad spectrum antibiotics. These are antibiotics that act against a wide range of disease-causing bacteria, but can also destroy the natural bacteria in your bowel, leading to overgrowth of C. difficile.

C.difficle infection can spread very easily because the spores can survive outside your body. For example, healthcare workers, people who are in hospital and visitors can spread the spores by touching a contaminated surface (such as furniture, toilets, sinks and taps). This is particularly common in hospitals and care homes.

You may be more likely to get C. difficile infection if you’ve had bowel surgery or if you have a condition such as HIV/AIDS where your immune system isn't able to fight infection as well it should.

Diagnosis of Clostridium difficile infection

As a number of different conditions can cause similar symptoms to those of C. difficile infection, it may be difficult for your GP or doctor to diagnose. He or she may ask you for a sample of your faeces (stool sample), which will be sent to a laboratory for testing.

Treatment of Clostridium difficile infection

If you have a mild C. difficile infection, the only treatment you may need is to stop taking the antibiotics that are causing you to become unwell. You will also need to make sure you drink enough fluids to replace those that you will have lost as a result of having diarrhoea. If you’re in hospital, you may need to have fluids given to you through a drip.

If you have a more serious infection, you may be prescribed a different antibiotic to the one you’ve been taking. Antibiotics usually prescribed for C.difficile infection are metronidazole or vancomycin. You will need to take the antibiotics for at least 10 days and make sure you finish your course of treatment, even if your symptoms clear up. You will usually be able to go back to work or school when you haven’t had diarrhoea for at least 48 hours.

Even if the antibiotics get rid of your infection, there is a possibility that it can come back. This happens to about three out of 10 people who develop C. difficile infection. If your symptoms return, let your GP know as soon as possible.

If you have severe bowel inflammation, you may need surgery to remove the infected part, but this is rare.

Prevention of Clostridium difficile infection

If you're infected with C. difficile or have been in contact with someone who has the infection, it's very important that you take steps to help stop it spreading to anyone else. You can do this by making sure you always wash your hands with soap and water after going to the toilet and before preparing or eating food. You should also regularly clean your kitchen and bathroom using disinfectant or household detergents.

If you’re in hospital and have C.difficle infection, you will usually be moved into a single room or to an area where other people also have the infection. The hospital staff will follow strict hygiene rules to prevent the C.difficle infection spreading. Any visitors you have should wash their hands with soap and water before and after they visit you. Alcohol gels aren’t effective at killing C.difficile spores, so won’t prevent the infection.

Video

See our video about Clostridium difficile infection:

How should I wash my hands to reduce the spread of hospital infection?

For answers to frequently asked questions on this topic, see Common questions.

For sources and links to further information, see Resources.