Clostridium Difficile

What is it?

Clostridium difficile is also known as C. difficile (or C.diff) and is one of the many bacteria found in the bowel (intestines) and the environment.

How is it spread?

C.difficile bacteria are found in the diarrhea of someone with an infection. People can be infected if they touch a surface covered with the bacteria and then touch their mouths. Surfaces can include toilets, bedpans, and bed railings. Contaminated hands can also spread the bacteria.
C.difficile does not usually make healthy people sick.

How does it make people sick?

Certain antibiotics and high doses over a long period of time can change the normal levels of bacteria in your intestine. This can allow C. difficile to thrive and produce toxins. These toxins can damage the bowel and cause diarrhea. 
C. difficile infection is usually mild but can be severe.

Who is at risk?

People in health care settings.
Older persons.
People with severe underlying illness.
Those taking certain antibiotics (especially over a long period of time).
Those taking stomach ulcer drugs (proton pump inhibitors).
What are the symptoms?
Symptoms include diarrhea (mild or severe), nausea, fever, abdominal pain or tenderness and loss of appetite.
How is it treated?
Those with mild symptoms may not need treatment.
For more severe infections, medication or surgery may be required.
Do not use any over-the-counter drugs to stop your diarrhea (e.g. Imodium®).
If diarrhea does not stop or comes back, contact your doctor
Be sure to drink plenty of fluids to keep hydrated.

What should I do at home?

Hand Hygiene

Wash your hands often for at least 15-20 seconds with soap and water, mainly after using the toilet and before eating or preparing meals.
Caregivers should wash their hands after providing care.
Wear gloves to handle body fluids or dirty items. Discard disposable gloves or clean rubber gloves after use.

House Cleaning

Remove any visible feces.
Use an all-purpose household cleaner and follow the directions on the label.
Wet the surface well and clean using good friction.
Allow the surface to air dry.
Wipe surfaces starting at the cleanest area and moving to the dirtiest area.
Pay special attention to the toilet and sink.

Cleaning clothes/other fabric

Remove any visible feces.
Wash items separately.
Clean in a hot water cycle with soap and dry in the dryer on high heat, if possible.
Dry clean where appropriate.

Cleaning Dishes

Use the dishwasher or clean by hand with soap and water.

For further information, please contact the Communicable Disease Control Program staff at 705-474-1400 or 1-800-563-2808, ext 5229.

References: Ministry of Health and Long-Term Care, Public Health Branch. (2014). Appendix A: Clostridium difficile Infection (CDI) outbreaks in public hospitals. Retrieved from: http://www.health.gov.on.ca/en/pro/programs/publichealth/oph_standards/i nfdispro.aspx Ontario Agency for Health Protection and Promotion. Provincial Infectious Disease Advisory Committee (PIDAC). (2013). Annex C: Testing, Surveillance and Management of Clostridium difficile. Retrieved from: http://www.publichealthontario.ca/en/BrowseByTopic/InfectiousDiseases/PID AC/Pages/PIDAC_Documents.aspx Public Health Agency of Canada. (2013). Fact Sheet-Clostridium difficile (C.difficile). Retrieved from: http://www.phac-aspc.gc/ca/id-mi/cdiff-eng.php Fact Sheet for WI-CDC-078 – 2015-04-16