Clostridium difficile Infection

This bacteria can grow in the large intestine after taking antibiotics

Clostridium difficile Cell
Clostridium difficile is a type of bacteria that is normally found in the human intestinal tract. There are some circumstances, however, that can cause it to grow out of control and cause diarrhea and other symptoms. Image © DR KARI LOUNATMAA / Getty Images

Clostridium difficile (or C difficile) is a bacteria that normally lives in the large intestine (colon). C difficile may cause inflammation of the colon (colitis) when it becomes too prevalent in the large intestine. This overgrowth of C difficile may take place after a person has taken antibiotics that have killed the helpful bacteria that live in the intestine.

While infection with C difficile can be serious, most cases can be treated effectively, although some people may need more than one round of treatment.

For people with inflammatory bowel disease (IBD), treatment for IBD may also need to be changed or increased while the C difficile infection is being managed. Prompt diagnosis and treatment is of course crucial to a better outcome, so people who have risk factors for C difficile and potential signs and symptoms will want to rule this infection out, which can be done with a stool test. 

How People Get Infected With C difficile

Some of the antibiotic types that are most associated with increasing the risk of C difficile infection include clindamycin; cephalosporins, monobactams, and carbapenems (CMCs); and fluoroquinolones. These antibiotics don't necessarily need to be avoided at all costs, but in some cases, a physician may prescribe another antibiotic when a person is considered to be at high risk of developing C difficile infection.

C difficile can be passed from person to person. A person may not have symptoms of having an overgrowth of C difficile, but he may still be able to pass the bacteria on to another person.

C difficile can be found outside the body on many surfaces, and is a special problem in hospitals and nursing homes. The bacteria is resistant to many antibiotics, but can be killed with a 10% chlorine bleach solution.

Treatment for C difficile Infection

Although it sounds counter-intuitive, C difficile infection is often treated with more antibiotics.

In many cases, a ten-day course of antibiotics is recommended, but in some cases, it could take much longer. The antibiotics most often used to treat C difficile are vancomycin and metronidazole.

One newer treatment that is only available in a handful of areas around the country is a fecal transplant. Fecal bacteriotherapy is the process by which some healthy stool is transplanted into the colon of someone infected with C difficile. The donor screening process is difficult, because the donor must be healthy. The fecal matter is treated very carefully before it is implanted in the person infected with C difficile. It sounds worse than it is; the fecal matter barely resembles stool when it is transplanted. The transplant is often done via an enema, a colonoscopy or a nasogastric (NG) tube. One review study discovered that fecal bacteriotherapy stopped diarrhea in 87% of the patients who were having recurrent diarrhea because of C difficile.

C Difficile Does Not Cause Ulcerative Colitis

No, an infection with C difficile will not cause ulcerative colitis. "Colitis" is a more general term that refers to inflammation of the colon. Colitis can have many causes, including infection with C difficile.

Colitis is just one sign of ulcerative colitis, but colitis can also be a sign of many other diseases and conditions including infections. Colitis may be self-limiting: it may go away after the condition that is causing it is treated. Ulcerative colitis is a condition that is lifelong and chronic.

A Word From Verywell

When there's unrelenting diarrhea, it's important to consider or rule out an infection with C difficile. People with IBD can develop an infection with C difficile, and it can be complicated to treat. Being careful about hygiene is important for everyone, but especially for people with IBD and other digestive conditions or chronic illnesses.

C difficile is not easy to kill, which is also why it's important to use disposable gloves when taking care of anyone who has diarrhea that might be from a bacteria.

Source:

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Cammarota G1, Ianiro G, Gasbarrini A. "Fecal microbiota transplantation for the treatment of Clostridium difficile infection: a systematic review." J Clin Gastroenterol. 2014 Sep;48(8):693-702. doi: 10.1097/MCG.0000000000000046.

Law CC, Tariq R, Khanna S, Murthy S, McCurdy JD. "Systematic review with meta-analysis: the impact of Clostridium difficile infection on the short- and long-term risks of colectomy in inflammatory bowel disease." Aliment Pharmacol Ther. 2017 Apr;45:1011-1020. doi: 10.1111/apt.13972. Epub 2017 Feb 16.

Vardakas KZ, Trigkidis KK, Boukouvala E, Falagas ME. "Clostridium difficile infection following systemic antibiotic administration in randomised controlled trials: a systematic review and meta-analysis." Int J Antimicrob Agents. 2016 Jul;48(1):1-10. doi: 10.1016/j.ijantimicag.2016.03.008.

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