About C. diff

What it is

Clostridioides difficile [klos–TRID–e–OY-dees dif–uh–SEEL], formerly known as Clostridium difficile and often called C. difficile or C. diff, is a bacterium (germ) that causes diarrhea and colitis. Colitis is an inflammation of the colon.

Symptoms

• Diarrhea
• Fever
• Stomach tenderness or pain
• Loss of appetite
• Nausea

Complications

Common

• Dehydration
• Inflammation of the colon, known as colitis

Rare

• Serious intestinal condition, such as toxic megacolon
• Sepsis, the body's extreme response to an infection
• Death

Risk factors

Who is at risk

While C. diff infection can affect anyone, most cases occur when you’ve been taking antibiotics or soon after you’ve finished taking antibiotics. People are up to 10 times more likely to get C. diff infection while taking an antibiotic or during the three months after, with longer courses potentially doubling their risk.23

Other risk factors

• Older age (65 or older)
• Recent stay at a hospital or nursing home
• A weakened immune system, such as organ transplant patients taking immunosuppressive drugs or people with HIV/AIDS or cancer
• Previous infection with C. diff or known exposure to the germs

Environmental risk factors

C. diff infection is more common among patients in healthcare settings, such as hospitals and nursing homes. This is because many people carrying C. diff stay or get treated in those facilities.

Causes and spread

C. diff germs spread from person to person in poop, but the bacteria are often found in the environment. Finding C. diff germs in the home is not unusual, even when no one in the home has been ill with C. diff infection.

When C. diff germs are outside the body, they become spores. These spores are an inactive form of the germ and have a protective coating allowing them to live for months or years on surfaces and in the soil. The germs become active again when you swallow these spores and they reach the intestines.

Healthy people don't get infected often even if the spores reach their intestines. If your immune system is weak or you've recently taken antibiotics, you could get sick. Taking antibiotics can affect your microbiome, making you more susceptible to illnesses like C. diff infection.

The microbiome

The microbiome is the neighborhood of good and bad germs that live in or on your body—including your stomach and intestines, your mouth, your urinary tract, and on your skin. Some of those germs can cause illness, but others are very important in keeping you healthy.

Microbiomes and C. diff

A healthy microbiome helps protect you from infection (like C. diff), but antibiotics disrupt your microbiome. Antibiotics that fight bacterial infections by killing bad germs can also get rid of the good germs living in the digestive tract that protect the body against infections. The effect of antibiotics can last as long as several months. If you come in contact with C. diff germs during this time, you can get sick.

Prevention

Any time antibiotics are used, they can cause side effects, including C. diff infection. Take antibiotics only when you need them. Talk to a healthcare professional about the best treatment for your illness.

Reduce the spread of C. diff by washing your hands with soap and water after using the bathroom and before you eat. You can take steps to reduce your risk of C. diff infection.

Diagnosis

If a healthcare professional suspects C. diff infection, they will review your symptoms and order a lab test of a stool (poop) sample.

Developing diarrhea is common while on or after taking antibiotics. Only in a few cases is that diarrhea caused by C. diff infection. If your diarrhea is severe, do not delay getting medical care.

Treatment and recovery

• Treatment for C. diff infection usually involves taking a specific antibiotic such as vancomycin or fidaxomicin for at least 10 days.
  • If you were taking an antibiotic for another infection, a healthcare professional might ask you to stop taking it if they think it's safe to do so.
• The healthcare team might admit you to the hospital. In this case, they will use certain precautions, like wearing gowns and gloves to prevent the spread of C. diff infection to themselves and other patients.

Reinfection

Some people get C. diff infection over and over again.

• If you start having symptoms again, seek medical care.
• For those with repeat infections, innovative treatments, including fecal microbiota transplants, have shown promising results.

What CDC is doing

CDC works with both federal and public health partners to reduce C. diff infections.

C. diff infections are an urgent problem in hospitals, nursing homes, and in communities. CDC is involved in education, research, and tracking and reporting efforts to reduce C. diff infections.