A rising infectious disease threat: bacterial infection of the colon known as C. diff

Clostridium difficile, better known as C. diff is a rising problem in hospitals, nursing homes and in private homes. It is a bacteria that can cause swelling and irritation of the bowel. This can cause several serious symptoms including fever, diarrhea and pain.

This is a very contagious infection. All people involved in the family must be educated as to how to prevent the spreading of this infection from family member to family member. It is also a huge problem in the hospital or nursing home setting due to the contagious nature of the illness. It is most common in persons taking antibiotics. And it is most common in geriatric patients because there systems are already weaker and susceptible.

A clostridium difficile infection can lead to colitis which is an infection of the colon. It can be mild or serious, but in can even lead to death if untreated, or treated very late in the progress of the infection.

It is a very difficult catch 22 situation. The C diff infection is caused by taking antibiotics. There are normally “good” bacteria in the bowel. These help with keeping the bowel healthy and functioning and assist in digestion. When you take antibiotics for any bacterial infection, such as a wound infection for instance, that antibiotic is killing the bad bacteria, but it is also killing the good bacteria. Without the good bowel bacteria present, this allows the C diff bacteria to grow rampantly. It releases harmful toxins which causes inflammation and irritation of the colon.

It is typical to notice you are having bloody diarrhea, serious fever as high as 105 degrees F. And abdominal cramping and pain. You may feel bloated and have increased flatulence. Some have reported an abnormal heartbeat.

Sometimes it is more difficult to diagnose due to the varying times that you may development symptoms related to taking an antibiotic. Usually symptoms occur within a week to 10 days of starting antibiotics. But sometimes symptoms may not appear until as late as a few weeks after you completed your dosing. And so it can be missed to associated the current symptoms with something that happened weeks before.

If you meet the criteria of suspicion for the infection, the confirmation will be complete by testing a stool sample for the C. Difficile toxins.

C. diff bacteria is found everywhere. In soil, air, water and human and animal feces. It is most common in hospitals of course due to the fact that most of the people there are unhealthy and ill from various causes.

The number one cause for contamination and cross infections is not using proper hand washing. The C. diff bacteria are passed in feces and spread to food and surfaces. If you touch a contaminated surface you may then unknowingly ingest the bacteria. This bacteria is very resilient and produces a very strong spore that can exist in a room for weeks or even months. So cross contamination could occur long after the patient no longer has symptoms.

Strangely enough the confirmed diagnosis will be treated with antibiotics. It is a bacterial infection after all. However, antibiotics different than the ones you had been taking will be used. Sometimes it is necessary to give the antibiotics by IV along with IV hydration to counteract the effects of fluid loss through diarrhea. But if the symptoms are not too severe, oral antibiotics may be prescribed. Frequently Cipro, Vancomycin and Flagyl will be utilized.
Probiotics are also useful to help rebuild the healthy bacteria in your bowel and to help prevent recurrent C. diff infections.

So once you know you are dealing with this persistent bacterial infection. What is the best way to keep you and your family healthy while the patient is being treated.

1. Good hand washing. You can not wash your hands enough. Before and after going to the bathroom. Before eating, after visiting with the patient, even if you don't think you touched anything in his room.
2. If possible there should be a separate toilet for the infected person.
3. Good housekeeping. All surfaces should be carefully cleaned with a detergent and a hospital-grade disinfectant or chlorine bleach. C. difficile spores can survive routine household disinfectants.
4. Good hydration, nutrition and rest for everyone involved, patient and caregiver.
5. If possible avoid the use of antibiotics unless absolutely necessary for a bacterial infection.
    

Michigan Infectious Disease Resources:

U Of M Department of Internal Medicine Infectious Diseases
Infection Disease Physicians in Michigan
Michigan Infectious Disease Society

Sources

WebMD.com

MayoClinic.com

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