Clostridium difficile (C.diff)

This leaflet gives you information on Clostridium difficile (C.diff) and how St Christopher’s is working to control it.

1 What is Clostridium difficile (C. diff)?

Clostridium difficile, also known as C diff, is a spore-forming bacterium that is quite commonly found in the human intestine where it can live without causing any harm. Problems arise when the balance of bacteria in the intestine is disturbed and C. diff multiplies, producing toxins and causing diarrhoea. Sometimes this can happen when a patient receives antibiotic treatment for an infection (although getting rid of C diff itself often needs use of an antibiotic, but of a particular kind). C. diff is the most common cause of hospital acquired diarrhoea.

2 What are the signs and symptoms of infection?

Symptoms can be mild or severe:

  • watery or bloody diarrhoea that can last from a few days to several weeks
  • abdominal pain
  • raised temperature.

3 How does C. diff cause disease?

If C. diff is able to multiply in the intestine, the diarrhoea it causes can range from mild to very severe. It also produces toxins that damage the lining of the gut causing ulceration. If left untreated it can cause perforation (a puncture) of the intestine and peritonitis which in frail people can be fatal.

4 How do you catch it?

C. diff is transmitted from person to person through poor hand hygiene. C. diff spores, unlike other bacteria, are not easily destroyed by heat and disinfection. The spores can enter the environment and survive for long periods in most surroundings such as toilets, commodes, bedclothes, skin and clothing. The spores are hardy and, unlike other bacteria, are not destroyed by heat and disinfectants.

When a spore passes through the stomach and changes to its active form in the intestine (gut), it can multiply and cause an infection, especially if the person is already ill or frail. Generally healthy people such as family or staff are not at risk.

5 How do you stop it spreading?

C. diff is usually spread on the hands of people who come into contact with infected patients, so good hand hygiene and cleaning are the most important ways of controlling the spread of the bacteria.

All our staff are aware of how important this is. Any staff who have patient contact attend yearly training to ensure they are aware of the precautions that need to be taken. They are trained to wash their hands thoroughly with soap and water when caring for patients with C. diff, and from time to time audits are carried out to ensure that our strict guidelines are being followed.

We have a team of dedicated cleaning staff who cover all areas of the hospice, and the cleaning is monitored regularly by our managers.

We have strict procedures to ensure that all equipment, such as commodes and bed pans, are properly decontaminated.

6 How will it affect me?

If you are staying in a bay, you will be moved to a single room with your own toilet or commode should you have diarrhoea. To be sure that the infection has cleared, you will stay in the room for a further two to three days after the diarrhoea has stopped.

Staff caring for you will wear gloves and a plastic apron. Your doctor will decide whether your treatment needs to be changed and whether you will need to be given an antibiotic for C. diff.

You will need to wash your hands frequently, especially before eating and drinking and after going to the toilet.

Most of your visitors can continue to visit, but those who have problems that might make them vulnerable to infection will be advised not to visit while you have diarrhoea. Your visitors should wash their hands with running water and liquid soap and dry them carefully after every contact.

If your clothing is to be laundered at home, it is advisable to use the hottest wash the fabric will tolerate.

Remember

  • C.diff is not harmful to fit and healthy people.
  • It can be harmful to ill people as they get infected more easily and it can be difficult to treat.
  • Hand washing and good hygiene stop it spreading.
  • Antibiotics are available to treat infection.