How Is A Cdi Diagnosed And Treated
A bowel movement sample may be sent to a lab to be tested for C. diff. The goal of treatment is to restore the healthy balance of bacteria to your colon. This should help stop your diarrhea.
- Antibiotics help treat or prevent an infection caused by bacteria. If antibiotics caused your CDI, you may need to stop taking them and switch to a different antibiotic.
- Immune globulin medicine may help treat severe or frequent CDI. You may need it to help your immune system fight infection.
- Surgery may be needed if your CDI is severe or damaged your colon. During surgery, part of your colon is removed.
What Are The Treatments For C Diff Infections
Certain antibiotics can treat C. diff infections. If you were already taking a different antibiotic when you got C. diff, your provider may ask you to stop taking that one.
If you have a severe case, you may need to stay in the hospital. If you have very severe pain or serious complications, you may need surgery to remove the diseased part of your colon.
About 1 in 5 people who have had a C. diff infection will get it again. It could be that your original infection came back or that you have new infection. Contact your health care provider if your symptoms come back.
How Is Clostridioidesdifficile Infection Diagnosed
Clostridioidesdifficile is diagnosed by testing the stool of patients who are having frequent liquid diarrhea such as 3 or more stools in a 24 hour period. In a severe case, a procedure called flexible sigmoidoscopy may be performed to confirm that the lower part of the intestine is inflamed. In this procedure a long, thin tube called a sigmoidoscope is placed inside the intestine to allow a doctor to visually examine the colon.
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Antibiotics: Both Good And Bad
In the 1920s, an English microbiologist named Alexander Fleming observed a curious phenomenon: when trying to grow bacteria, he saw that a mold had developed in some of his tubes. Surprisingly, in the tubes with the mold, the bacteria did not grow and were even killed. After a lot of work, he identified a molecule that was produced by the mold, which could kill the bacteria. Since the mold was a fungus called Penicillium, he named the molecule penicillin. This was the first antibiotic. Antibiotics are a class of drugs that can specifically kill bacteria. When a human or an animal is suffering from a bacterial infection, the first line of therapy is most often an antibiotic. Antibiotics have been best sellers in pharmacies all over the world for the past 80 years. This is the good side of antibiotics.
How Does It Spread
The C. diff bacterium comes from feces. You can develop an infection if you touch a contaminated surface and then touch your mouth.
In addition, the spores of C. diff are resistant to many chemicals used for cleaning. As a result, they can stick around for a long time.
While anyone can develop a C. diff infection, some people have an increased risk.
Things that can increase your risk include:
- taking antibiotics, especially a long course of broad spectrum antibiotics
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Proper Hand Hygiene Is Critical
To prevent the spread of the germ, proper hand hygiene among medical staff must be practiced. As hard as it is to believe, many doctors and other staff members are not washing their hands regularly.
One study found a median compliance rate of only 40% among medical staff. Interestingly, the researchers found that compliance rates were lower in intensive care units , as compared to other settings . Additionally, doctors were less likely to wash their hands , as compared to nurses .
Why arent medical providers washing their hands frequently enough? Its likely a combination of forgetfulness, time-related pressures, exhaustion, skin irritations, and apathy.
Mild Or Moderate Infection
Many people develop mild or moderate watery diarrhoea. They may also have some crampy tummy pains, a feeling of sickness and a high temperature . This is similar to the symptoms that occur with many other mild or moderate bouts of gut infection . Symptoms may last from a few days to several weeks. In mild cases, symptoms often clear away without any specific treatment.
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How Do People Get C Diff Infections
C. diff germs are found in feces, which is why good handwashing is so important after using the bathroom. People can become infected if they touch items or surfaces that are dirty with C. diff germs and then touch their mouth. These germs can live outside the body for a long time.
C. diff infection most often happens in people who have recently taken antibiotics and have had recent admissions to a health care facility, such as a hospital or nursing home. However, it is becoming more common for people to get C. diff infection without having a recent hospitalization or nursing home stay. These infections are called community-associated C. diff infections. These people often have recently taken antibiotics.
Antibiotics And Risk Of C Diff Recurrence
Most antibiotics carry a risk for C. diff infections, however, some antibiotics carry a higher risk due to their spectrum of coverage. The below table provides select antibiotics and their associated risk level for C. diff recurrence.Select Antibiotics and Risk of C. Diff Recurrence
- Loss of appetite
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Tip #: Limit Close Contact With Others
Like we mentioned in Tip #7, contact precautions are used in the hospital when a C. diff infection is severe. While you may not have a severe diarrhea infection, protect yourself and others by staying home. Take a sick day at work or keep your child home from school so that the infection does not spread. Besides, no one wants to be at work or school with diarrhea!
What Causes Clostridioidesdifficile
When a person takes antibiotics, the good germs in the intestines are killed off making it easier to become infected by the Clostridioidesdifficile germ. The germ is found in stool , and is spread to other people by unwashed hands, contaminated surfaces, or objects.
In a healthcare setting, the germs have been found on objects such as toilets, bathroom fixtures, bed rails, and rectal thermometers. The germ is able to survive for a very long time on a variety of surfaces.
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Symptoms Of C Diff Infection
C. diff. infections can range from mild to severe.
Mild symptoms can include:
- Watery diarrhea .
- Stomach pain or tenderness.
- Frequent, watery diarrhea .
- Severe stomach pain or tenderness.
- Loss of appetite
- Low-grade fever of up to 101°F in children or 100°F to 102°F in adults
- Blood or pus in your stool.
- Symptoms begin after taking an antibiotic.
- Symptoms last longer than 3 days or get worse.
How Is It Diagnosed
The diagnosis of C. difficile infection is primarily clinical, although many different tests are available. Clinicians should become familiar with the testing approach used by their laboratory. For a single episode of illness, testing should be performed only once because further testing does not improve diagnostic accuracy and may yield false-positive results.12,13
Many patients are colonized with C. difficile, but signs and symptoms occur only when toxin is produced. To reduce false-positive results, appropriate selection of patients for testing is important. One study demonstrated that many patients inappropriately tested for C. difficile infection did not have diarrhea or had recently used laxatives.14
An alternative to a one-step approach using nucleic acid amplification testing or enzyme immunoassay is a multistep protocol in which the first step is detection of the glutamate dehydrogenase antigen, which is produced by all C. difficile isolates.16 If this rapid and sensitive test is positive, samples should then undergo analysis to verify toxin production . Further studies are needed to clarify the testing strategy that leads to the most favorable patient outcomes.11,16,17
Testing for cure should be avoided in asymptomatic patients because the toxin may be produced after clinical disease has resolved.2
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Are There Any Complications
While most C. diff infections dont cause any long-term problems, more serious ones can lead to complications, such as:
- Toxic megacolon. Toxic megacolon is a rare condition that causes a grossly enlarged colon. Left untreated, your colon can rupture. This can be fatal.
- Bowel perforation. Damage from the infection or toxic megacolon can cause a hole to form in your intestines.
- Kidney injury. In severe cases of C. diff infection, rapid dehydration can lead to acute kidney injury.
Despite its resistance to many cleaning products, there are several things you can do to prevent yourself from developing or spreading a C. diff infection.
Follow these tips to reduce your risk:
- Wash your hands regularlywith soap and warm water. This is especially important after using the bathroom and before eating.
- Dont take antibiotics unnecessarily. Keep in mind that antibiotics are only effective for bacterial infections and wont treat a viral infection, such as the flu or common cold.
- Keep surfaces in high-use areas clean. This includes bathrooms and kitchens. Try to periodically clean these areas with products containing bleach. Bleach is effective against the C. diff bacterium.
How Is Clostridium Difficile Treated
Fortunately, there are a few antibiotics that act specifically against C. difficile and these can be used to treat infected people. In about 20% of the cases however, the infection may relapse, meaning that it returns after treatment. Sometimes multiple relapses may occur . The main way to help people with relapsing C. difficile is to restore their normal colonic flora. This can be done with probiotics, for example. Probiotics are pills or capsules containing microorganisms that have been selected and grown in laboratories because they are known to grow well in the intestines and can restore normal colonic flora.
A few years ago, a doctor had a different idea for restoring the colonic flora of a patient suffering relapsing C. difficile diarrhea. Why not restore the damaged colonic flora with the help of the flora from a healthy person who has not taken antibiotics? A team of doctors in the Netherlands did this and it worked! They took 250 g of feces from a healthy person and diluted it in water. Then, they inserted it into the patients intestines with a tube called a catheter. Most patients were cured! So now we know that fecal transplant is an effective technique for treating patients with relapsing C. difficile diarrhea.
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How Do I Clean My House After C Diff
Regularly clean the bathrooms with the appropriate products hydrogen peroxide wipes have proven to be the most effective against C. diff. Remove and dispose of any soiled materials as soon as possible do not try to save them. Avoid unnecessary antibiotic use antibiotics help bacteria like C. diff build resistance.
Probiotics To Beat The Bacterium
Probiotic supplements are the best way to restore the balance of the natural bacterial colony in your gut. Poor diet and the use of antibiotics can cause these beneficial floras to become depleted, and probiotics can help restore numbers.
When the balance is in favor of beneficial strains again, bacteria like C. diff dont stand a chance.
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Specifically, there are three probiotic bacterial strains that have been shown to combat C. diff effectively. Incorporating these strains into your regular diet or taking in supplement form can prevent the harmful bacteria from taking over or if taken after infection, symptoms can be reduced and recovery will be much faster.
S. Boulardii: This is probiotic yeast, which has been shown to counteract the activities of C. diff within your gut. This beneficial yeast can inhibit the activities of inflammatory markers as well as reduce intestinal wall permeability. These actions reduce inflammation and prevent C. diff toxins from binding. A protease secreted by the S. Boulardii inhibits the production of the toxins produced by C. diff, which prevents it from damaging your intestinal walls.
Lactobacillus: This is a species of probiotics that have been used in numerous studies to combat the effects of C. diff. These bacteria have the ability to colonize in your gut and can protect you from pathogenic invaders.
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Clostridium Difficile And Its Family
Clostridium difficile belongs to a family of bacteria that are among the deadliest microbes on earth. Another member of the family, Clostridium tetani causes tetanus Clostridium botulinum is responsible for a deadly disease called botulism and Clostridium perfringens is the main cause of gas gangrene. All these bacteria can kill a human within a few hours! Fortunately, C. difficile does not kill as easily as its family members but unfortunately it is much more common and has become one of the most frequent pathogens encountered in hospitals .
All members of the Clostridium family share three properties that explain why they are so dangerous. First, they are anaerobic bacteria. This means that they cannot survive in the presence of oxygenthey can only grow where oxygen is absent. There is one important place in the body where oxygen is absent: our intestines. That is where C. difficile can be found.
Second, members of the Clostridium family can form spores. A spore is a way for these bacteria to survive every time they are threatened by the environment. Whenever the bacterial cell faces a mortal enemy, like the presence of oxygen, extreme heat, or even an antibiotic, it produces a thick shell and locks itself inside. The bacterium can remain inactive for months or even years! When the environment becomes less hostile, the spore will turn back into an active bacterium and regain the ability to multiply.
Who Gets Clostridium Difficile Infection
Anyone who takes a course of an antibiotic is at risk of developing C. difficile infection. However, the risk of C. difficile infection is usually very low and depends on the type of antibiotic. As a rule, the longer the course of the antibiotic, the greater the risk of developing C. difficile infection.
Although C. difficile infection is often linked with patients in hospital, infection occurs in only 13.7 per 100,000 days of admission to hospital. Many cases start in the community, especially in nursing homes.
The exact number of cases that occur in hospital patients is difficult to determine. However, it is common. Also, outbreaks can occur in hospitals and care homes. About 3 in 10 people who become infected develop symptoms. Commonly this is just a mild or moderate bout of diarrhoea. However, it sometimes develops into pseudomembranous colitis.
C. difficile infection is more common in older people. Over 8 in 10 cases occur in people over the age of 65. This is partly because older people are more commonly in hospital. Also, older people seem to be more prone to this infection. It is rarely a problem with children. As a rule, the longer the stay in hospital and the older you are, the greater your risk of developing C. difficile infection. C. difficile infection is also more likely in people who have a weakened immune system or other underlying health problems.
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How Do I Know If I Have A C Diff Infection
Clostridium difficile is a spore-forming bacterium that is commonly found in the human intestine and can live there without causing any harm.
When the balance of bacteria in the intestine is upset, C diff multiplies and produces toxins, causing diarrhea. Approximately 5 out of 10 people infected with C diff have no symptoms. They can, however, spread the infection to others.
Others could exhibit symptoms, such as:
C Diff Infection Symptoms & Signs
A person with a mild C. diff infection may have symptoms of
- a low-grade fever,
- watery stools for 5-10 days , and
- mild abdominal cramps and tenderness.
A person with severe C. diff infection may have symptoms of
- a high fever of 102 F to 104 F ,
- more than 10 watery stools a day with blood, and
- severe abdominal pain and tenderness.
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What Can Be Done To Prevent The Spread Of C Difficile
As with any infectious disease, frequent hand hygiene is the most effective way of preventing the transmission of healthcare associated infections. Hand washing with soap and water is important during C. difficile outbreaks and is one of the best defences against further spread of the bacteria.
If you do not have access to soap and water, frequent use of alcohol-based hand rubs is encouraged. Most healthcare facilities provide alcohol-based hand rubs at entrances. Be sure to use them, but be aware that they are less effective than washing with soap and water as they do not destroy C. difficile spores.
If you work in or visit a hospital or long-term healthcare facility, wash your hands often preferably with soap and water, especially after using the toilet. Gloves should be worn when caring for a patient with C. difficile infection or if in contact with his/her environment. Use a new pair of gloves when caring for each patient. Be sure to wash your hands with soap and water after removing your gloves.
When antibiotics are prescribed, follow your doctor, pharmacist, or healthcare provider’s instructions and the directions on the label. Keep taking the antibiotics as prescribed to kill all of the C. difficile bacteria.
If you have concerns about C. difficile and medication you are currently using, talk to your doctor, pharmacist, or healthcare provider.