Clostridium Difficile infection (CDI) is a common hospital-acquired intestinal infection in many hospitals but seems to be growing in the community setting as well. Risks for Clostridium Difficile, or C. Diff, may be changing as new data is collected. Although hand hygiene may have increased through the use of alcohol-based hand sanitizers, these waterless hand cleaners are ineffective in getting rid of C. Diff spores.
What is C. Diff?
Clostridium Difficile is a bacterium that produces spores and is responsible for approximately one-fourth of cases of antibiotic-associated diarrhea. It is known by several different names:
- C. Diff
- C. Difficile
- CDI (Clostridium Difficile Infection)
Most cases of C Difficile infection occur in people who have some sort of illness. The elderly, those who are very young, people who are receiving medications that can alter immunity such as cancer treatment, and those with certain types of chronic illnesses and autoimmune disorders tend to be more at risk for developing a CDI than the general public. Those who have taken antibiotics in the last couple of months are at a higher risk to develop a C. Diff infection as well.
This “superbug” can be found in the feces, or stool, of a person experiencing a C. Diff infection. Someone that touches a contaminated surface, such as a commode, rectal thermometer, or tub can then transmit the bacterium to another surface or person. According to the Center for Disease Control and Prevention’s (CDC) April 22, 2009 online article entitled “Have you heard? Some retail meats contain C. Difficile,” this bacteria has been identified in some food producing animals, such as beef and dairy cattle, as well as pets, like cats and dogs.
Symptoms of a C. Diff infection may include:
- frequent bowel movements that tend to be watery
- fever
- decreased or no appetite
- nausea
- pain or tenderness in the abdomen
Complications of the intestinal infection may produce more serious symptoms, such as colitis or sepsis and on rare occasions may result in death. Healthy people are much less likely to become seriously ill from a CDI.
C. Diff Infections Appear in Facilities and in Community
Inpatients in hospitals and long-term care facilities (nursing homes) tend to be the highest risk for acquiring a CDI. People in the community who have altered immunity and those who are using antibiotics or have recently taken antibiotics tend to be higher risk than others in the community setting. Some people considered low risk have also acquired CDI, including pregnant women and healthy people who have not recently taken antibiotics.
CDI seems to be increasing in the community setting. Visits to healthcare clinics and contact with the 3-5% of the population who may be colonized with CDI but have no symptoms may be more common sources. Although no studies have proven a case of CDI resulting from ingesting food contaminated with C. Diff, studies are looking at this possibility. At this time C. Diff is not considered a foodborne illness.
Prevention and Treatment of C. Difficile
People with a C. Diff infection can expect to take antibiotics for ten days. This treatment is different than the antibiotics that tend to result in the development of CDI. Studies related to the association between C. Diff infections and certain antibiotics may help healthcare providers in medication selection in the future. Contact precautions are instituted in hospitals when a person is diagnosed with a CDI with similar precautions implemented in other facilities.
The Environmental Protection Agency (EPA) has no registered disinfectants that specifically claim to inactivate Clostridium Difficile and its spores, but household chlorine bleach (hypochlorite) may help disinfect areas in which contamination is suspected. Unfortunately, alcohol-based disinfectants, including hand sanitizers, are not effective against C. Diff, so washing hands with soap and water in areas where C. Diff is suspected would be a safer practice according to the CDC’s July 22, 2005 online article entitled “Clostridium Difficile – Information for Healthcare Providers.”
Clostridium Difficile Strikes Inpatients and Communities
Clostridium difficile infections are a growing concern as a cause of facility-acquired and community-associated infections. Proper handwashing with soap and water and disinfection of contaminated surfaces with chlorine bleach seem to be most effective in curtailing C Diff infections.
Contact precautions may protect others, particularly those with altered immunity and the elderly, from contracting this potentially serious intestinal bacterial infection that is a common source of diarrhea related to antibiotic use. Limiting antibiotic use can help prevent CDI as well as other resistant infections such as MRSA and VRE. Since C. Diff has been discovered in some foods and some low risk people have developed this infection, future studies may help determine whether or not CDI may also be a foodborne illness.
This article is for informational purposes only and should not be considered medical advice.
Source:
CDC series of articles on Clostridium Difficile
Katrena Wells - Katrena Wells is a RN in NC with 17 1/2 years of experience in oncology, an educator since 1995, and has taught exercise classes since ...
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