• What is Clostridium difficile?
• Who gets Clostridium difficile-associated disease?
• What are the symptoms?
• How is Clostridium difficile transmitted?
• How can Clostridium difficile transmission be prevented in hospitals and other health care settings?

What is Clostridium difficile?

Clostridium difficile (also known as C.difficile) is a bacterium associated with diarrhea and intestinal inflammation among patients or residents in health care facilities. The disease is called Clostridium difficile-associated disease (CDAD). Patients taking antibiotics or who have serious health conditions (e.g. immune-compromised patients) may be at risk of contracting Clostridium difficile-associated disease.

Who gets Clostridium difficile-associated disease?

Healthy people are usually not affected by Clostridium difficile. People who have other conditions and use antibiotics are at risk of developing Clostridium difficile diarrhea. The use of antibiotics can change the levels of good microorganisms found in the intestines. When there are fewer good microogranisms, Clostridium difficile can produce toxins that lead to an infection.

What are the symptoms?

The symptoms of Clostridium difficile-associated disease include:

• watery diarrhea
• fever
• loss of appetite
• nausea
• abdominal pain and tenderness

In rare cases, Clostridium difficile can cause death. Commonly, the infection causes diarrhea, which can lead to complications such as dehydration.

How is Clostridium difficile transmitted?

Clostridium difficile is present in feces. It is spread from person to person through hand contact. Clostridium difficile may be transferred to patients via the hands of health care personnel who had contact with contaminated patients or their feces.

People can become infected if they touch objects or surfaces that are contaminated with feces and them touch their mouth.

How can Clostridium difficile transmission be prevented in hospitals and other health care settings?

Health care workers who care for symptomatic patients should use "contact precautions" as outlined in the Public Health Agency of Canada guidelines:

• Routine Practices and Additional Precautions for Preventing the Transmission of Infection in Health Care (Canada Communicable Diseases Report, volume 25S4, July 1999)
• Prevention and Control of Occupational Infections in Health Care (Canada Communicable Diseases Report, volume 28S1, March 2002)

The following precautions should also be taken:

• Wash hands frequently between entering patients' rooms.
• Use gloves during patient's care.
• Use gowns if soiling of clothes is likely.
• Dedicate equipment for use when working with infected patients.
• Continue these precautions for 72 hours after diarrhea has resolved.

For environmental cleaning and disinfection use an approved hospital grade disinfectant as indicated in the Public Health Agency of Canada Communicable Diseases Report on Infection Control Guidelines - Hand Washing, Cleaning, Disinfection and Sterilization in Health Care (volume S8, December 1998).

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Document last updated on November 24, 2006

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