Infection control and prevention
What is clostridium difficile?
Clostridium difficile is a cause of diarrhoea, which may be acquired in hospital. In most cases it causes a relatively mild illness but occasionally, particularly in the very frail and elderly, it can be serious.
If a patient is taking or has taken antibiotics and gets diarrhoea, they may have a clostridium difficile infection. Patients at an increased risk of the infection are the elderly and those on antibiotics.
What type of illness does it cause?
A small percentage of the population carry the clostridium difficile organism in their gut, with no ill effects. However, when in hospital, almost all patients who develop this type of diarrhoea are taking, or have recently been given, antibiotics. Though diarrhoea is the most common symptom, stomach pains and fever may also occur.
For most people this is a mild but uncomfortable illness and they will make a full recovery. Some elderly patients can become ill with dehydration caused by the diarrhoea and occasionally patients may develop more serious bowel problems. It is rare for Clostridium difficile to spread to other parts of the body such as the blood stream.
How is the disease diagnosed?
Diagnosis is confirmed by the laboratory following the testing of a faeces specimen which must be obtained should clostridium difficile be suspected.
How is clostridium difficile treated?
If patients have a mild illness, stopping their antibiotics (if clinically possible) and replacing lost fluids – either by mouth or intravenous drip – usually leads to a rapid improvement in their health.
However it is sometimes necessary to give specific treatment against clostridium difficile and two antibiotics – Vancomycin and Metronidazole – are very effective and can be taken by mouth.
Some patients may need more than one course of antibiotics. This will be reviewed on an individual basis.
How is the spread of clostridium difficile controlled?
Patients should always be encouraged to wash their hands after toileting.
Alcohol gel should not be used for patients with clostridium difficile. Because the bacteria forms spores, it can survive for long periods of time in the environment – for example on floors and around toilets. Infected patients will be isolated from non-infected patients in a single room.
Staff will wear disposable gloves and full length gown when caring for infected patients. Rigorous cleaning with warm water and a chlorine based detergent is the most effective means of removing the spores from the environment.
Visitors will be asked to wear disposable gloves and aprons when visiting infected patients. Visitors must also wash their hands with soap and water before leaving the patients room.
Is there a risk to a patients’ relative?
Because most patients with this condition have recently received antibiotics, patients’ relatives are at little risk of catching the illness.
However if any of these people are receiving antibiotics there could be some risk of infection and they should pay special attention to their hand washing.
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How can this infection be prevented?
The key to preventing and controlling the spread of this infection is the sensible use of antibiotics and good hand hygiene.
If at all possible, only short courses of antibiotics are prescribed which only
kill a small range of bacteria. These are preferred to broad-spectrum ones that affect a wide range of bacteria.
This minimises any bacterial changes in the bowel, which is a key factor in developing the condition. When a patient is identified as having clostridium difficile diarrhoea, the infection control measures described will reduce the risk of it spreading to others.
It is important to maintain good personal hygiene after discharge in order to minimise the risk of the infection reoccurring. If symptoms of diarrhoea re-occur following your discharge from hospital, please ensure that you inform your GP as soon as possible of recent diagnosis of clostridium difficile.
You will have been given a clostridium difficile alert card, please keep for one year and use as advised on the card.
Need more information?
South Tees Hospitals NHS Foundation Trust would like your feedback. If you wish to share your experience about your care and treatment or on behalf of a patient, please contact The Patient Experience Department who will advise you on how best to do this.
This service is based at The James Cook University Hospital but also covers the Friarage Hospital in Northallerton, our community hospitals and community health services.