C. difficile

Clostridium Difficile (also known as C. difficile and C. diff) is a bacterium that produces a toxin that can cause an inflammation of the intestinal tract. It can be part of the normal bacteria that live in the large intestine. It can also be acquired during hospital admission. Nosocomial C. difficile is also called hospital-acquired C. difficile. The usual symptoms are diarrhea, with or without fever, and abdominal pain.

Transmission

C. difficile is most commonly spread by person-to-person contact. The microorganisms can also be spread on the hands of health care providers and medical equipment, if not properly disinfected.

Taking certain antibiotics can change the normal balance of bacteria in your large intestine making it easier for C. difficile to grow and cause an infection. 

Detection and precautions 

If a C. difficile infection is suspected, you will be asked to give a stool (feces) sample that will be tested for the bacteria and/or its toxins. Most importantly, you and your visitors should pay particular attention to good hand washing and follow the instructions as given to you by the health care staff.

Precautions

Why are precautions needed? Precautions are needed because surfaces like toilets and common areas that hands touch can become contaminated with the bacteria. The bacteria can survive for a long time if they are not properly cleaned. In order to prevent spread to other patients in the hospital, it will be necessary for everyone to follow these precautions.

Hand washing is the first defense against spreading any type of bacteria, including C. difficile. 

If an inpatient is identified with C. difficile-associated diarrhea, they will be placed in a private room and activities outside the room may be limited. Medical care is not impacted. Hands must be washed after using the toilet or bedpan, before eating and every time a patient leaves the room. It is also very important for all staff and visitors to wash their hands when they come in and leave a room. Do not be shy about reminding everyone to wash.

For inpatients, signs may be placed outside the room to remind everyone about precautions. Staff will wear gowns and gloves. Sometimes equipment (e.g., commodes) will be left in an isolation room specifically for an infected person's use. 

Treatment

If the C. difficile needs treatment, a doctor will order an antibiotic to be taken orally. People with mild symptoms may not need treatment.

Performance

North York General Hospital regularly monitors and reviews infection rates and uses this information to execute best practice protective measures and continually improve patient care and safety.

The rate of hospital-acquired C. difficile is calculated as the total number of patients with hospital-acquired C. difficile per 1,000 inpatient days, and the absolute number of cases in the monthly reporting period. 

Go to the Health Quality Ontario website to see NYGH's rate of C. difficile infections in hospital patients.

Learn more about C. difficile on the Canadian Patient Safety Institute website.

To find out more about C.difficile, visit the Ministry of Health and Long-Term Care website.