Clostridioides difficile (C.diff) (previously known as Clostridium difficile)
Information for patients from the Infection Prevention and Control team
What is Clostridioides difficile?
Clostridioides difficile is also known as C.diff. It is one of a large number of different bacteria that can live in the bowel. It is kept in check by the other normal or “good” bacteria, which prevent it from multiplying or over-growing.
Approximately 2 to 5% of the UK population carry C.diff in their bowel without it causing any problems. It is particularly common in elderly patients, babies, and infants.
What causes Clostridioides difficile?
If you carry C.diff in your bowel and are treated with antibiotics for an infection, the antibiotic treatment can upset the balance of bacteria in your bowel. Some of the “good” bacteria are killed off. If C.diff is also present it can begin to multiply and produce toxins. This can irritate the bowel and cause diarrhoea and abdominal pain.
C.diff bacteria can survive in the environment for a long time and patients may get C.diff from this source.
What are the signs and symptoms of C.diff infection?
C.diff infection can be mild or severe.
Patients with C.diff develop very loose or runny bowel motions (diarrhoea). These bowel motions may also contain mucus or a “jelly-like” substance, and have a “farm-yard” or “manure” type smell. Patients may have several episodes of diarrhoea a day.
Some patients may have abdominal (stomach) pain, a temperature, and feel generally unwell.
How is C.diff diagnosed?
A specimen of your poo (called a stool specimen) will be sent to the Microbiology Laboratory if:
you develop diarrhoea in hospital, and
you are taking or have recently completed a course of antibiotics.
How is C.diff treated?
If you have C.diff, you will only need treatment if you have diarrhoea.
If you have diarrhoea, you will be prescribed antibiotics to treat the C.diff infection. You can have these either in tablet form or through a drip. Your symptoms should begin to settle down within a couple of days.
If your symptoms are severe, you may need more than one course of antibiotics. Particularly if you have been on several other antibiotics.
Is C.diff dangerous?
Severe C.diff infection can sometimes cause complications, such as:
ulceration and bleeding of the bowel wall, or
perforation of the bowel.
The risk is higher in elderly people and people who have serious health conditions. Most patients respond to treatment very quickly.
What precautions are taken in hospital?
If you have C.diff infection or we think you do, we will move you to a side room. This is to protect other patients from cross infection. You will have access to your own toilet.
Your visitors do not need to take any special precautions. However, before leaving your room they must wash their hands using liquid soap with running water.
What happens when I am discharged from hospital?
You can be discharged from hospital as soon as you are well enough.
No special care needs to be taken in the home beyond normal hygiene measures, such as washing your hands after using the bathroom.
If you feel well, you can resume your normal daily routines such as shopping, and visiting friends and family.
What if my symptoms return?
Symptoms can return, even after a course of treatment. If this happens, you may need another course of treatment. If your symptoms return after you have been discharged home, you must tell your GP.
What is the Green NHS “CDI Important Information” card?
The Infection Prevention and Control Team will provide you with a green NHS “CDI Important Information” card. It is important that you keep this card with you. On each visit show this card to any doctor, pharmacist, dentist, or other healthcare provider. It lets them know that you have had a C.diff infection. And they should take care if you need antibiotics in the next few months, as this may trigger a return of symptoms.
What if I have further questions?
If you have any questions or concerns, please speak to either the nurse-in-charge of your ward or the matron. If they are unable to help you or you need further information, please contact a member of the Infection Prevention and Control Team.
Queen Elizabeth the Queen Mother (QEQM) Hospital, Margate
Telephone: 01843 225544 extension 725-4234 or 725-3625Kent and Canterbury Hospital, Canterbury
Telephone: 01227 766877 extension 722-4216 or 722-6810William Harvey Hospital, Ashford
Telephone: 01233 633331 extension 723-8202 or 723-8198
References
East Kent Hospitals University NHS Foundation Trust. Infection Prevention and Control. Guidelines on the Prevention, Management and Control of Clostridioides difficile (CDI) Infection.