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C. Diff Infection: Symptoms, Causes, Diagnosis And Treatment
Clostridioides difficile (C. Diff) is a type of bacteria that can cause colitis, a serious inflammation of the colon. Infections from C. Diff often start after you've been taking antibiotics. It can sometimes be life-threatening.
When you have C. Diff, the symptoms can range from mild to severe.
Mild symptoms can include problems such as:
In more serious infections, there may be blood or pus in the stool. This can happen because C. Diff can cause the colon (also called the large intestine) to get inflamed. When this happens, tissue in the colon can bleed or make pus. Other symptoms of a serious infection include:
If your C. Diff infection is severe, you could get severe intestinal inflammation. Your colon could also get enlarged and you could develop an extreme response called sepsis. All of these problems are serious and could send you to the hospital.
If your diarrhea from C. Diff is very severe, get medical help quickly. Severe diarrhea can lead to life-threatening dehydration.
What does C. Diff smell like?
C. Diff may change the odor of your stool. Some people say it's an unusually strong, foul odor they hadn't noticed before. Others report a sweetness to the odor, which may be caused by bile in your stool.
What does C. Diff poop look like?
If you have a condition, such as irritable bowel disease (IBD), that frequently causes diarrhea, it's helpful to know what your diarrhea looks like during a flare. This can help you see differences in the way it looks at other times and seek help promptly. For example, sometimes diarrhea caused by C. Diff looks like hot cereal — fluffy or mushy. Sometimes, you might see blood in your stool or mucus. Other times, it might have a green appearance.
C. Diff exists all around us. It's in the air, water, soil, and the feces of humans and animals.
Clostridium difficile (C. Diff) is a highly contagious bacterial infection of the colon. It's typically caused by taking certain antibiotics, which can interfere with the balance between good and bad bacteria in your gut.
C. Diff bacteria that are outside the body turn into spores that can live on surfaces for weeks or months. These spores are not "active," but they can turn active after you swallow them and they get into your intestines. Some people have the bacteria in their intestines and never have any symptoms. But for others, the bacteria make toxins that attack the intestines.
A new strain of C. Diff bacteria makes larger amounts of toxins. These types are hard to treat with medications.
C. Diff bacteria spread in health care facilities, such as hospitals or nursing homes, where workers are more likely to come into contact with them and then with patients or residents.
You can also become infected if you touch clothing, sheets, or other surfaces that have come in contact with feces and then touch your mouth or nose.
Older adults in health care facilities are most at risk, especially if they're taking antibiotics. That's because the human body contains thousands of different types of bacteria -- some good, some bad. If the antibiotics kill enough healthy bacteria, the ones that cause C. Diff could grow unchecked and make you sick.
The antibiotics that are most linked to a risk of C. Diff infection are:
An increasing number of younger people also develop C. Diff infections, even without taking antibiotics or being in a hospital. Failure to wash your hands thoroughly after being exposed to the bacteria can lead to infection.
You also have higher odds of getting C. Diff if you have:
Women have higher chances of getting C. Diff than men. You're also more at risk for the disease if you're 65 or older. And the more times you've had the disease before, the greater your odds of developing C. Diff.
If a C. Diff infection isn't treated quickly, you could become dehydrated due to severe diarrhea. This loss of fluids might also affect your:
A C. Diff infection also can lead to rare problems such as:
Leaking from your colon. Fluid can leak from your colon into the abdominal cavity, resulting in a loss of proteins called albumin from your colon. Low albumin levels can cause leaky blood vessels and swelling in your face, feet, and hands.
Pseudomembranous colitis. Caused by toxins produced by C. Diff, this type of colitis attacks the cells of your intestinal lining, resulting in ulcers and plaques there.
Reactive arthritis. Severe C. Diff may cause joint pain, inflammation and swelling, an immune response that occurs in a small fraction of people with the infection.
Toxic megacolon. Your colon dilates and can't release gas or stool. This could cause it to swell and rupture. It can be life-threatening without emergency surgery.
Bowel perforation. This is a hole in your large intestines that allows dangerous bacteria to escape. It can lead to a dangerous infection called peritonitis.
Long-term problems after C. Diff
The more severe your C. Diff infection is, the higher the likelihood of complications. If you get C. Diff a second time, there's a 40% chance you'll get it again.
Your colon may heal more slowly if you had a severe form of C. Diff, have taken antibiotics for a long period (including for C. Diff), are immunocompromised, or are older than 65.
Yes. C. Diff is very contagious. Externally, C. Diff is transmitted to your gut through your mouth. Many of us already have C. Diff in our intestines that other, helpful bacteria keep in check. When antibiotics kill off these helpful bacteria, C. Diff can take over in your gut.
The spores C. Diff creates are resistant to the types of substances that kill other bacteria such as heat, acid, antibiotics, and disinfectant cleaners. C. Diff can live for months on surfaces.
How long is C. Diff contagious?
If you're being treated for Clostridioides difficile, you should stay away from other people for at least 48 hours after your symptoms disappear. Sometimes, you can have no symptoms but still have C. Diff in your colon that can be spread to others. That's why frequent handwashing with warm water and soap is so important. Hand sanitizer does not work on C. Diff.
C. Diff incubation period
It's not well-known how long the incubation period for C. Diff is. Studies have shown the infection can appear anywhere from 2 days to 3 months after you're exposed.
Antibiotics may have triggered your infection, but some types of these drugs target C. Diff. They include:
Talk with your doctor about the side effects of these antibiotics.
It's important to replace fluids that you lost from diarrhea. Drink plenty of fluids that have water, salt, and sugar, such as broth and fruit juices.
If there's been damage to your intestines, you may need surgery to remove the affected areas.
C. Diff diet
If you have watery diarrhea, eat starchy foods such as:
C. Diff recurrence
Sometimes, a Clostridioides difficile infection can come back. Studies have shown that the people most at risk for a recurrence of C. Diff are:
Other studies have indicated that kidney patients on dialysis may have a higher risk for C. Diff. This is because dialysis patients often require antibiotics to treat various complications due to their treatment.
Doctors sometimes recommend a treatment to help repopulate the colon with healthy bacteria. It's often done by putting another person's stool in your colon using a device called a colonoscope. The procedure is called fecal microbiota transplant (FMT).
Donors are screened carefully to make sure they're not passing along infections or parasites.
If you're in a hospital or long-term health care facility, you can do several things to protect yourself from C. Diff. For example:
Another way to help prevent C. Diff is to avoid unnecessary antibiotics. Talk this over with your doctor and see if there are other treatment options. And don't take antibiotics without a doctor's OK.
Many C. Diff infections are mild and short-lived, but others can be quite serious. Take precautions, and don't hesitate to seek medical help if you have symptoms.
C. Diff and probiotics
After having C. Diff, it's important to reintroduce "good" bacteria back into your gut. These bacteria, called probiotics, can help limit the growth of C. Diff. Fermented foods with live cultures such as yogurt, kefir, miso, and sauerkraut contain probiotics. Probiotics can also be taken as supplements.
There is limited evidence about the role probiotics play in helping to treat or prevent C. Diff. Some data suggests that combinations of the good bacteria Lactobacillus and S. Boulardii may help prevent C. Diff infections in high-risk patients, but more research is needed.
Clostridioides difficileis a very contagious bacterial infection that causes symptoms such as frequent watery diarrhea, abdominal cramping, nausea, fever, blood in your stool, and a rapid heartbeat. C. Diff usually occurs after a course of certain antibiotics, known as broad-spectrum antibiotics, which kill good and bad bacteria in your gut and allow C. Diff to take over. Risk factors for C. Diff include being over age 65; a stay in a hospital, nursing home, or long-term care facility where treatment with antibiotics is common; and a history of previous C. Diff infection. Severe C. Diff can cause serious complications. If you've recently taken a course of antibiotics, see your doctor if you have watery diarrhea for more than a couple of days, develop a fever, or have severe cramping and abdominal pain.
Is it OK to be around someone with C. Diff?
You may have to take care of someone with C. Diff, but it's important to take precautions. These include isolating the person as much as possible, wearing and promptly throwing away disposable gloves when you care for them, and washing your hands frequently. Some disinfectants don't work on C. Diff, but cleaners containing chlorine (bleach) do. Be sure to disinfect any surfaces the person with C. Diff touches.
Can C. Diff be treated at home?
Yes. If your symptoms are mild, your doctor will ask you to stop taking the antibiotics that may have caused your C. Diff infection and start you on a new course of antibiotics that specifically target C. Diff. Most people make a full recovery in 1 to 2 weeks.
How do you get rid of C. Diff permanently?
You might always have C. Diff in your gut but not get sick or be contagious. If you have multiple infections with C. Diff, a procedure called fecal microbiota transplant from a stool sample of a healthy donor can restore bacterial balance in your gut to help ward off C. Diff.
Once you have C. Diff, do you always have it?
After being treated, you may still have some C. Diff left in your gut, but the balance of other bacteria in your gut should help keep C. Diff in check. A C. Diff relapse may not be your original infection but a new one.
Antibiotics Promote C. Diff Infection By Killing Gut Bacteria
RALEIGH, N.C., Jan. 6 (UPI) -- Bacteria in the gut are involved in many of the body's functions, from the creation of neurons in the brain to regulating chemicals that help break food down.
Scientists at North Carolina State University found in experiments with mice that a single course of antibiotic treatment can open a window for Clostridium difficile, or C. Diff, to thrive because bacteria responsible for altering bile acid were killed off, according to a new study.
Primary bile acids are made in the liver from cholesterol to aid in digestion and fat absorption, and in controlling lipoprotein, glucose, drug, and energy metabolism. The acids travel through the intestinal tract to the large intestine, where other bacteria convert them to secondary bile acids. These secondary acids inhibit the growth, and infection by, C. Diff.
"These findings are a first step in understanding how the gut microbiota regulates bile acids throughout the intestine," said Casey Theriot, an assistant professor of infectious disease at North Carolina State, in a press release. "Hopefully they will aid the development of future therapies for C. Difficile infection and other metabolically relevant disorders such as obesity and diabetes."
In the study, published in the journal mSphere, the scientists identified 26 primary and secondary bile acids in mice, defining their levels before and after treatment with an antibiotic.
The scientists then added C. Diff spores to concentrations of the acids, finding primary bile acids allow spores to germinate, regardless of antibiotic treatment, which included the broad-spectrum antibiotics cefoperazone, clindamycin and vancomycin.
When the spores passed into concentrations that mimicked the large intestines of mice, altered secondary bile stopped C. Diff from growing. When bacteria that turn primary bile acids into secondary acids had been killed during antibiotic treatment, C. Diff was able to grow.
Scientists said the experiments showing the importance of gut bacteria to preventing at least one bacterial infection -- and how antibiotics can prevent the inhibition of its growth -- may help guide future research into preventing the infections.
Baddest Bug: C. Diff Hits Half A Million Americans - NBC News
More than 450,000 Americans get infected with the deadly bug Clostridium difficile each year, according to a new report. And almost all cases are caused by the overuse of antibiotics.
"C. Difficile was responsible for almost half a million infections and was associated with approximately 29,000 deaths in 2011," the team of researchers reported Wednesday in the New England Journal of Medicine.
That's almost twice as many deaths as any other survey has shown before for the infection, usually called C. Diff for short. "This national estimate of C. Difficile infection is higher than previous U.S. Estimates (240,000 to 333,000)," they wrote.
"The driver of this is antibiotic use."
The number's probably been undercounted for so long because many people get sick after they leave the hospital. And the study showed people are not just getting infected in hospitals. They are getting infected in doctors' offices, the dentist's chair, and in other healthcare settings.
"This is the first study that really highlights the important burden of this infection," said Dr. Ghinwa Dumyati of the University of Rochester Medical Center, who helped conduct the study with the Centers for Disease Control and Prevention.
"The driver of this is antibiotic use."
Clostridium difficile bacteria are very hard to fight for two reasons. One, they release a toxin that, once in the body, cannot be cleared up by drugs. Second, they release spores that are not killed by hand sanitizer or antibiotics and that can lurk in hospital nooks and crannies, or inside the body.
Worse, there's a new strain that emerged in 2000 and that causes 30 percent of cases. "It is more easily transmitted than other strains," said the CDC's Dr. Cliff McDonald, who worked on the study. "It also does seem to cause more severe disease."
C. Diff causes severe diarrhea, inflammation and sepsis. Even before this new data, it was known to be the No. 1 cause of deadly hospital infections.
"Because hand sanitizers don't kill the spores, it is essential to use soap and water to remove them," Dr. Michael Bell, deputy director of CDC's Division of Healthcare Quality Promotion, told reporters in a teleconference. There is, he says, no room for error.
The toxin damages the lining of the intestines. It creates inflammation and allows the germs and the toxins they make to get into the bloodstream.
People with C. Diff infections have an imbalance in the normal population of microbes that keep us healthy, and it's very difficult to recover from a C. Diff infection. This also explains why it's not usually best to use antibiotics to treat a C. Diff infection — the drugs are what helped cause the infection in the first place, by killing the "good" bacteria in the bowel, allowing C. Diff to take over.
"Once somebody gets C. Diff, it usually means your normal bacteria in the bowel are so damaged that returning to normal can be very difficult," Bell said. The new study found that C. Diff came back in 20 percent of patients, and that one out of every nine patients 65 or older died within 30 days of a C. Diff diagnosis.
"If we can improve antibiotic prescribing, we can expect to see better C. Diff rates," Bell said.
"Antibiotics are clearly driving this whole epidemic."
Fighting C. Diff. Costs hospitals up to $4.8 billion each year, CDC says. More than 100,000 nursing home patients get a C. Difficile infection every year.
"Because hand sanitizers don't kill the spores, it is essential to use soap and wáter to remove them."
Previous research showed C. Difficile killed about 14,000 Americans a year, causing 12 percent of all healthcare-associated infections. Researchers funded by the CDC found last year that about 650,000 people developed hospital-associated infections in 2011 and that 75,000 died. Other data showed an estimated 107,700 C. Difficile infections in hospitals.
For the new C. Diff study, the CDC-led team did an actual count of C. Diff cases in 2011. They found 15,461 cases in 10 regions of the country. About two-thirds were associated with some sort of health care, but only 24 percent of people actually got sick while in the hospital.
From this, they extrapolated across the whole population to come up with 453,000 cases.
The good news is that cases are going down. CDC has documented a 10 percent decrease in hospital-onset C. Difficile infections between 2011 and 2013. The Health and Human Services Department will start penalizing hospitals that do not reduce such cases in 2017.
One possible treatment is fecal transplant, which may help a patient infected with C. Diff get a healthy batch of gut bacteria from someone else.
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