What is Clostridium difficile?
Clostridium difficile, also known as Clostridiodes difficile (C. difficile or C. diff), is a type of bacterium.
This bacterium is:
- Anaerobic gram-positive bacilli, meaning it doesn’t require oxygen to survive.
- It produces spores that can withstand heat and acidic conditions, allowing the bacterium to persist in the environment for extended periods.
It can cause symptoms such as diarrhoea and colitis.
- It can easily spread through ingestion or contact with contaminated objects.
How is C. difficile infection related to antibiotic use?
C. difficile infection is associated with the use of antibiotics, especially broad-spectrum antibiotics. Prolonged antibiotic use disrupts the normal gut flora, which normally inhibits the growth of C. difficile. This disruption allows C. difficile to multiply and produce toxins that lead to diarrhoea and potentially severe complications like pseudomembranous colitis.
Transmission of C. difficile :
C. difficile bacteria reside in the faeces and can be transmitted through:
- Direct contact
- Contaminated food
- Contaminated surfaces
C. difficile can also produce spores, which are highly resilient and can survive in the environment for up to 5 months. These spores can withstand heat, stomach acid, antibiotics, and even some disinfectants. Healthy individuals can carry C. difficile spores in their digestive system without becoming ill, but individuals with weakened immune systems or underlying health conditions are at greater risk of infection.
Risk factors for C. difficile infection include :
- Prolonged antibiotic use and hospitalization
- Advanced age (65 years and older)
- Acid-reducing medications
- Underlying health conditions such as inflammatory bowel disease, cancer, diabetes, or conditions that weaken the immune system
Chemotherapy or immunosuppressive therapy
Symptoms of C. difficile infection include :
- Diarrhoea, which may be watery with blood
- High fever
- Abdominal pain or cramping
- Bloating
- Nausea
- Loss of appetite
- Weight loss
- Severe cases may lead to death, while asymptomatic carriers can spread the infection.
Prevention of C. difficile infection involves :
- Thorough handwashing before and after eating, after using the bathroom, and after touching surfaces or objects in public areas.
- Limiting the use of antibiotics and using them appropriately, following medical advice.
- Maintaining personal hygiene.
References:
1.Cohen SH, Gerding DN, Johnson S, Kelly CP, Loo VG, McDonald LC, et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). Infect Control Hosp Epidemiol 2010;31:431-55.
2.Debast SB, Bauer MP, Kuijper EJ. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. Clin Microbiol Infect 2014;20 Suppl 2:1-26.
3.Issarachaikull R, Khantipong M, Sawatpanich A, Suankratay C. PROSPECTIVE EVALUATION OF A NOVEL TWO-STEP PROTOCOL FOR SCREENING OF CLOSTRIDIUM DIFFICILE INFECTION IN HOSPITALIZED ADULT PATIENTS. Southeast Asian J Trop Med Public Health 2015;46:1037-48.
4.Leffler DA, Lamont JT. Clostridium difficile Infection. N Engl J Med 2015;373:287-8.
