Clostridium difficile

Published by Bupa's Health Information Team, April 2010.

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

Clostridium difficile is a type of bacteria. Clostridium difficile infection usually causes diarrhoea and abdominal pain, but it can be more serious.

About Clostridium difficile infection

Clostridium difficile (C. difficile) is a type of bacteria that doesn't usually cause problems in healthy people. Most babies and young children have C. difficile in their large bowel, but it doesn't usually have a harmful effect. A small number of adults have C. difficile in their large bowel, but it doesn't make them ill because it's controlled by other types of bacteria. However, some antibiotics destroy the bacteria that usually stop C. difficile causing any problems. When this happens, C. difficile can multiply and cause symptoms.

C. difficile infection is much more common in older people - around eight out of 10 people who develop it are over 65. People in hospital are particularly vulnerable to C. difficile infection because they are already ill and often older. They may also be taking antibiotics.

Over 100 types of C. difficile have been identified but one type, known as 027, causes a greater number of serious infections.

C. difficile can survive for long periods of time outside your body, for example on surfaces and clothes, by creating spores. These spores can only be destroyed by cleaning thoroughly with soap and water or disinfectant.

Symptoms of Clostridium difficile infection

Your symptoms will vary depending on how seriously you're infected. The main symptoms include:

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

Sometimes, C. difficile can cause inflammation and bleeding in your large bowel. This is called pseudomembranous colitis. C. difficile can also lead to your bowel perforating (tearing), blood poisoning and inflammation of the inside of your abdomen.

Sometimes C. difficile infection can be fatal. However, recently there has been a fall in the number of deaths involving C. difficile. This fall reflects a huge drive by the Department of Health to increase standards of hygiene in hospitals.

Causes of Clostridium difficile infection

C. difficile infection is usually caused when you're taking antibiotics for another illness. These medicines destroy the bacteria that usually stop C. difficile causing any problems. You're more at risk of C. difficile infection if you're taking broad spectrum antibiotics (antibiotics that are effective against a wide range of disease-causing bacteria).

C. difficile spores are found in the diarrhoea of people who have C. difficile infection and can be easily passed on. This may be through hand-to-hand contact with someone who is infected or through contact with contaminated objects such as bedpans, toilets or surfaces. The spread of C. difficile infection is more likely in hospitals and places such as nursing homes where there are many people in close contact with one another.

You may be more at risk of C. difficile infection if you have had surgery to your digestive system or if you have a condition that means your immune system isn't able to fight infection as well it should.

Diagnosis of Clostridium difficile infection

A doctor may not be able to diagnose C. difficile infection by your symptoms alone, as many different conditions cause similar symptoms. Diarrhoea is a common side-effect of many antibiotics and isn't usually caused by C. difficile infection.

Your doctor will usually take a sample of your faeces, which will be sent to a laboratory for testing to see whether it contains C. difficile toxins.

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 the disruption of your bowel's usual bacteria. You're likely to need treatment to replace the fluids that you will have lost as a result of having diarrhoea. You may need to have fluids given to you through a drip.

If you have a more serious infection, you will probably be prescribed a different antibiotic to the one you have been taking. You will need to take this for at least 10 days and finish your course of treatment. However, even if these antibiotics get rid of the infection, there's a possibility that it will come back. This happens to about two to three out of ten people who develop the infection. This is because C. difficile spores are often resistant to treatment with antibiotics and are difficult to destroy. If you get C. difficile infection again, you may be prescribed the same antibiotic again or a different treatment.

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 avoid spreading the disease to anyone else, particularly older people or others who may be at a higher risk. You can do this by making sure you always wash your hands with soap and water after going to the toilet and before preparing food or eating. You should also regularly clean your kitchen and bathroom using disinfectant or household detergents.

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.