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Clostridium Difficile (C. difficile, CDI)

Introduction

Clostridium difficile is a spore-forming anaerobic Gram-positive bacillus (rod) that causes diarrhoeal illness, which can progress to a more severe conditions including perforation of the bowel and intra-abdominal sepsis.

It affects especially the elderly and the debilitated patient, although there is some evidence to demonstrate that certain strains are capable of causing disease in otherwise healthy individuals.

Sometimes having antibiotics can affect the normal balance of bacteria in the bowel which can mean that C. difficile may have a chance to multiply and cause infection

How does C. difficile affect you?

The symptoms of C. difficile infection can vary from nothing to diarrhoea of varying severity, abdominal (tummy) pain or tenderness, nausea (feeling sick) and sometimes a high temperature

How is C. difficile identified?

The nurses will ask patients with recognised symptoms of C. difficile to provide a sample of faeces and send it to the laboratory to be examined.

How are patients with C. difficile nursed?

Ideally a patient with C. difficile infection will be nursed in a side room to prevent the bacteria spreading to other patients on the ward.

Can C. difficile be treated?

Yes, in two main ways: by stopping, if possible, the antibiotics that have allowed the C. difficile to multiply, and by using certain other antibiotics to kill the C. difficile.

Your doctor can explain what the best treatment for you is.

How can the spread of the bacteria be minimised?

By thorough hand washing using soap and water by everyone involved in your care. Alcohol hand rub is ineffective and therefore not advised. Doctors, nurses, and other staff who care for patients with C. difficile will wear gloves and aprons when attending to them. This will help prevent the spread of infection to other patients

What about visitors?

There is no need for visitors to wear gloves and aprons unless they are helping with your care, such as washing you or helping you with meals.

All visitors should wash their hands with soap and water in the nearest sink to the bed, before and after visiting you.

There is no risk to healthy family and other visitors (including pregnant women and children), as long they wash their hands.

Are there any special precautions when you leave hospital?

Normal procedures of routine hand washing and cleaning of the home environment are all that are needed. Wash hands with soap and water, especially after using the toilet and before handling food. Clean surfaces in bathrooms, kitchens and other areas on a regular basis with household detergent. If you still have C. difficile diarrhoea, any soiled clothes, bedding and towels etc should be washed separately in a washing machine at the highest temperature possible for that fabric. Once your diarrhoea has resolved there is no need to separate items.

Further general information can be found here;

  • Information Leaflet for patients, relatives & visitors
  • Public Health England – C.difficile guidance
  • NHS Choices – C.difficile guidance

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