Clostridioides difficile, or C. difficile (formerly called Clostridium difficile), is a bacterium that causes inflammation of the colon, called colitis, and is a leading cause of healthcare-associated diarrhea. People affected by C. difficile commonly have watery diarrhea at least three times a day for two or more days. Other symptoms of C. difficile include fever, loss of appetite, nausea, and abdominal pain. The elderly and people who require long term use of antibiotics are at a higher risk of becoming infected with C. difficile. The infection is usually spread from the hands of a healthcare worker who has touched equipment contaminated with fecal material, such as toilets or rectal thermometers. C. difficile spores can live for long periods of time on these surfaces. Treatment of C. difficile often includes changing the patient’s antibiotics, which can sometimes be effective. However, there is a chance the infection can return and worsen. Other treatments for C. difficile, such as “fecal transplants”, may be effective for helping patients with repeat infections, but they may not be widely available.
Publication: Living with C. difficile
This booklet provides basic information about caring for yourself and others diagnosed with C. difficile
- C. difficile infographic
- CDC Vital Signs: Making Health Care Safer - Stopping C. difficile Infections
Information about C. difficile in Vermont
Individual cases of C. difficile are not reportable in Vermont, so the Health Department does not have data on the number of cases. However, clusters of cases or outbreaks are reportable. Some Vermont hospitals report data on C. difficile to the Centers for Disease Control and Prevention’s (CDC’s) National Healthcare Safety Network. A CDC report on healthcare associated infections showed that Vermont’s C. difficile infection rate was 21% lower than the national baseline in 2017.
C. difficile infections affect a large population of patients in the United States annually (almost 500,000 in 2011) and can be fatal. To prevent and control C. difficile infections, healthcare providers can:
- Prescribe and use antibiotics carefully. Once culture results are available, check whether prescribed antibiotics are correct and necessary.
- Order a C. difficile test if the patient has had three or more unformed stools within 24 hours without a known cause (e.g., recent laxative use).
- Practice Contact Precautions, such as gloves and gowns, when treating patients with C. difficile.
- Wear gloves and follow with handwashing because alcohol-based hand sanitizers do not kill C. difficile.
- Clean room surfaces daily with bleach or another EPA-approved spore-killing disinfectant while treating a patient and upon patient discharge or transfer.
- When a patient is transferred, notify the new facility if the patient has C. difficile.
Additional resources for healthcare providers
- CDC resources for healthcare providers
- CDC Guideline for Environmental Infection Control in Health Care Facilities
- 2016 CDC presentation on C. difficile epidemiology, laboratory testing, and prevention
- SHEA and IDSA Clinical Practice Guidelines for Clostridium difficile Infection in Adults
- Resources from the Association for Professionals in Infection Control and Epidemiology