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Information on C difficile

What is C difficile?

C difficile or C diff is one of the many types of bacteria that can be found in stool (a bowel movement).

Where does C difficile come from?

C difficile is not new. Although people may associate it with health care settings, it does not come from hospitals, long-term care homes or laboratories. It is found in the intestine, occurring naturally in 3-5% of adults without causing symptoms.

What causes C difficile?

C difficile can be picked up on the hands from exposure in the environment and can get into the stomach once the mouth is touched, or if food is handled and then swallowed. Once in the stomach, the bacteria usually will not cause any problems unless the other bowel bacteria are disturbed, which can happen when antibiotics are taken. The use of antibiotics increases the chances of developing C difficile associated disease (CDAD) as it alters the normal level of good bacteria found in the intestines and colon.

What is C difficile associated disease?

C difficile associated disease or CDAD occurs when antibiotics kill your good bowel bacteria and allow the C difficile bacteria to grow. When C difficile grows it produces toxins which act like a poison. These toxins can damage the bowel and may cause diarrhea.

CDAD is usually mild but it can be severe. In severe cases, surgery may be needed, and in extreme cases CDAD may cause death. C difficile is the most common cause of infectious diarrhea in hospitals or long-term care homes.

The main symptoms of CDAD are watery diarrhea, fever and abdominal pain or tenderness.

Who can get CDAD?

CDAD usually occurs during or after the use of antibiotics. Old age, presence of other serious illnesses and poor overall health may increase the risk of CDAD.

How will my Doctor know that I have CDAD?

If you have symptoms of CDAD, your doctor will ask for a sample of your watery stool. The laboratory will test the stool to see if C difficile toxins are present.

How is CDAD treated?

Treatment depends on how sick you are. People with mild symptoms may not need treatment.
For more severe cases antibiotics are required.

How is CDAD spread?

When a person has CDAD, the bacteria in the stool can contaminate surfaces such as
toilets, handles, bedpans, or commode chairs. If we touch these surfaces, our hands can become contaminated. If we then touch our mouth without washing our hands, we can become infected. Soiled hands can also spread the bacteria to other surfaces.

My loved one is in hospital and has CDAD. Can I visit them?

Yes. If you plan to visit a loved one in hospital who has CDAD, for your safety, the following precautionary measures must be followed:
  1. Put on gown and gloves each time you go into the patient’s room. These are available at the door of each patient room.
  2. When leaving, dispose of the gown and gloves in the garbage inside the patient’s room.
  3. Wash your hands for at least 15 seconds with soap and water or alcohol-based hand rub each time you enter or leave the patient’s room. Alcohol-based hand rub is available outside most patient rooms.
  4. Visit one patient per visit to the hospital.
  5. Do not use the patient’s bathroom. Visitor’s bathrooms are located in the lounge on most units.
  6. Follow the direction of your loved one’s health care provider.
How do I prevent the spread of CDAD?

If you are in the hospital and have CDAD, precautionary measures will be put in place to ensure others do not become infected until you are free from diarrhea for at least two days. Your activities outside the room may be restricted. All health care staff will wear a gown and gloves when caring for you. Everyone must clean their hands when leaving your room. As well, a thorough cleaning of your room and equipment will be done to prevent the spread of the infection.

At home, always wash your hands after using the bathroom, touching dirty surfaces, and before eating or preparing meals. Cleaning your hands is the most important way to prevent the spread of CDAD.

Where can I get more information about C difficile and CDAD?

Please visit the Provincial Infectious Diseases Advisory Committee’s website at www.health.gov.on.ca/english/providers/program/infectious/pidac/pidac_mn.html.