Clostridium Difficile Infection (CDI)

What is C. difficile?

C. difficile (Clostridium difficile) is a bacteria. C. difficile can be part of the normal bacteria in the large intestine and is one of the many bacteria that can be found in stool (a bowel movement). C. difficile infection occurs when other good bacteria in the bowel are eliminated or decreased allowing the C. difficile bacteria to grow and produce toxin. The toxin produced can damage the bowel and cause diarrhea. C. difficile is one example of a hospital-acquired infection and is one of the most common infections found in hospitals and long-term care facilities. C. difficile has been a known cause of health care associated diarrhea for about 30 years.

What are hospital-acquired infections?

Sometimes when patients are admitted to the hospital, they can get infections. These are called hospital-acquired infections. In the case of C. difficile, this may mean that symptoms began 72 hours after admission to the hospital; or that the infection was present at the time of admission but was related to a previous admission to that hospital within the last four weeks.

Who is at risk for C. difficile?

Healthy people are not usually susceptible to C. difficile. Seniors, and people who have other illnesses or conditions being treated with antibiotics and certain other stomach medications, are at greater risk of an infection from C. difficile.

What are the symptoms of C. difficile?

The usual symptoms are mild but can be severe. Main symptoms are watery diarrhea, fever, abdominal pain /tenderness. In some cases there may not be diarrhea. Blood may or may not be present in the stools.

How do you get C. difficile?

C. difficile is the most common cause of hospital associated infectious diarrhea. Since it can be part of the normal bacteria that live in the large intestine, taking antibiotics can change the normal balance of bacteria in your large intestine making it easier for C. difficile to grow and cause an infection. Old age and the presence of other serious illnesses may increase the risk of C. difficile disease.

How does C. difficile spread?

When a person has C. difficile, the germs in the stool can soil surfaces such as toilets, handles, bedpans, or commode chairs. When touching these items, your hands can become soiled. If you then touch your mouth, you can swallow the germ. Your soiled hands can spread germs that can survive for a long time on other surfaces if not properly cleaned. The spread of C. difficile occurs due to inadequate hand hygiene and environmental cleaning; therefore, proper control is achieved through consistent hand hygiene and thorough cleaning of the patient environment. Good hand hygiene i.e. washing hands thoroughly and often is the single-most effective way to prevent the spread of infectious diseases like C. difficile. TBRHSC is committed to implementing the MOHLTC’s “Just clean your hands” Program.

How is C. difficile diagnosed?

The laboratory will test watery stool to determine if any C.difficile toxins are present.

How is C. difficile treated?

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

What precautions are used to prevent the spread of C. difficile in the hospital?

If you are in the hospital and have C. difficile diarrhea, you will be put on precautions until you are free from diarrhea for at least two days. Your activities outside the room may be restricted. Precautions may include placement in a private room, extra environmental cleaning and the use of gown and gloves by both staff and visitors. Everyone MUST clean their hands when leaving your room.

How does TBRHSC control the spread of C. difficile?

TBRHSC is fortunate to have a newer facility with a larger number of private and semi-private rooms as well as better access to hand washing sinks and/or alcohol based hand sanitizers for patients, staff and visitors. Although the spread of microorganisms does happen, we try to minimize this spread by ensuring a clean environment, clean equipment or use of single-use equipment, and by providing education to all staff on infection prevention and control.

Does TBRHSC track C. difficile cases?

Yes, TBRHSC tracks all C.difficile cases that enter the facility. Click here for TBRHSC Patient Safety Indicators.

How the C.difficile rates are calculated:

Number of new hospital-acquired cases of C. dificile Infecyion (CDI) at TBRHSC x 1000
Number of patient days

This rate represents the incidence rate of hospital-acquired CDI assoctiated with TBRHSC per 1000 patient days, 18 years and older.