C. difficile is an anaerobic, gram positive, spore forming bacillus. This organism can cause significant disease in humans. C. difficile spores can lie dormant inside the colon until they are disrupted, usually by an antibiotic. Antibiotics can disrupt the normal flora in the colon and prevent C.difficile from transforming into an active, disease causing form. When this happens, C. difficile produces toxins that can inflame the colon, causing colitis (inflammation of the colon). In severe cases, the toxins can destroy the lining of the colon, causing erosion and necrosis.
Certain populations appear to be at more risk than others for acquiring C.difficile. They are the elderly population, those persons receiving antibiotics, and those with prolonged hospital stays. Additionally, patients undergoing surgery and those who have compromised immune systems are also at risk. Immunosuppression can occur due to certain medications, such as chemotherapy and prolonged antimicrobial medications.
Signs and symptoms of C. difficile disease may include the following:
- Watery diarrhea 3 or more times a day for 2 or more days
- Abdominal cramps and tenderness
- Nausea and dehydration
- Loss of appetite
- Weight loss
Preventive measures are paramount in the reduction of C. difficile cases. Methods for minimizing exposure include the following:
- Early detection
- Contact precautions ( gowns and gloves when handling patients with known C. difficile)
- Strict hand hygiene with soap and water
- Disposable hospital equipment when feasible
- Cautious use of antibiotics
- Patient, family education
Transmission of C. difficile occurs primarily in healthcare facilities. Public awareness and global education (patients, families, visitors and staff alike) all improve the opportunity to reduce the occurrence of this potentially life threatening illness.