Infection Control for Healthcare Level 2 (VTQ)

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Clostridium difficile Infection

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Clostridium Difficile (C. difficile): Symptoms, Transmission, and Prevention

Overview of Clostridium Difficile (C. difficile)

Clostridium difficile (C. difficile) is a bacterial infection primarily affecting the digestive system, commonly occurring in hospital settings.

Symptoms of Clostridium Difficile Infection (CDI)

The symptoms of Clostridium difficile infection (CDI) vary from mild to severe:

  • Mild to Moderate: Regular bouts of foul-smelling, watery diarrhoea (3-5 times a day), abdominal cramping, and pain.
  • Severe: More frequent bouts of diarrhoea (10-15 times a day), high fever (38°C or above), severe abdominal cramping, dehydration, nausea, loss of appetite, and weight loss. In severe cases, it can lead to colitis or toxic megacolon.

Transmission and Spread

Clostridium difficile spreads easily through contact with contaminated surfaces or objects:

  • Spores can survive for weeks to months on surfaces.
  • Ingestion occurs when touching contaminated surfaces and then touching nose or mouth.

Diagnosis and Treatment

Diarrhoea while taking antibiotics doesn't always indicate CDI. A blood test confirms the infection.

Treatment involves:

  • Stopping antibiotics causing the infection for mild cases.
  • Using different antibiotics for severe cases.

Most cases respond well to treatment within 2-3 days and clear completely within 7-10 days. However, relapses can occur in about 1 in 4 cases.


CDIs can be prevented by:

  • Practising good hygiene in healthcare environments.
  • Regularly washing hands with soap and water, as alcohol hand gel is ineffective against C. difficile spores.
  • Cleaning surfaces with bleach-containing products.

Statistics and Trends

In England, the number of CDI cases has decreased significantly, but challenges remain:

  • 17,414 reported cases in 2011 compared to 52,988 in 2007.
  • Emergence of a new strain (NAP1/027) causing more severe infections.
  • Rise in community-acquired CDI cases outside healthcare settings.