C difficile
Clostridium difficile (C diff) infection typically resolves within two weeks of starting antibiotics, however, many people become reinfected one to three weeks afterward.

Patients with Clostridium difficile (C diff) infections usually recover within two weeks of starting antibiotic treatment and probiotics.

Many people, however, become reinfected and require additional treatment. Most recurrences occur one to three weeks after stopping antibiotic therapy though some occur up to two or three months later.

Asymptomatic C diff infections usually go away without intervention. When a C diff infection becomes symptomatic, one in every five infections resolves without the need for medication.

  • C diff bacteria cannot grow in the air, but they can survive in the environment for long periods by transforming into spores.
  • Because spores are extremely difficult to kill even with disinfectants, they may be present on surfaces and equipment even after a thorough cleaning.

5 factors that increase the risk of C diff infection

  1. Consumption of antibiotics: Antibiotics can increase the risk of Clostridium difficile (C diff) infection, especially if a person has been taking antibiotics that work against multiple types of bacteria (broad-spectrum antibiotics), several different antibiotics at the same time, or antibiotics for a long period. People are more likely to contract this disease if they have weak immunity.
  2. Being in the hospital or nursing home: Many cases begin in the community, particularly nursing homes. In general, the longer a person stays in the hospital and the older they are, the more likely they are to contract C diff infection.
  3. Older adults: C diff infection is more common in the elderly. More than 8 out of 10 cases occur in people older than 65 years. This is partly because older people are more likely to be hospitalized. Furthermore, older people appear to be more susceptible to this infection, possibly due to weakened immune systems or other medical issues that put them at greater risk. Children are less likely to become infected.
  4. Previous C diff infection: If a person has had C diff infection in the past, they are more likely to get it again in the future. Their bowel may become more sensitive to antibiotics if they have had a C diff infection.
  5. Inflammatory bowel disease (ulcerative colitis or Crohn’s disease): People who have colitis as a result of inflammatory bowel disease are more likely to contract C diff infection. In this case, C diff infection could occur in the absence of previous antibiotic treatment.

Each episode of C diff increases the likelihood of a subsequent recurrence. Many patients may have multiple occurrences during their stay in a healthcare facility or must return to a hospital multiple times because of its recurrence.

The risk is that C diff colitis can quickly and unexpectedly escalate into a medical emergency. A person should seek medical attention as soon as they notice any signs of infection.

How do I know if I have a C diff infection?

Clostridium difficile (C diff) is a spore-forming bacterium that is commonly found in the human intestine and can live there without causing any harm.

When the balance of bacteria in the intestine is upset, C diff multiplies and produces toxins, causing diarrhea. Approximately 5 out of 10 people infected with C diff have no symptoms. They can, however, spread the infection to others.

Others could exhibit symptoms, such as:

Some who are infected develop serious problems with symptoms such as:

What are the treatment options for C diff?

Even though Clostridium difficile (C diff) infections are caused by antibiotics, antibiotics are the treatment of choice for C diff and may include:

It can take a long time for the gut microflora to reestablish itself after the treatments. For the next two to eight weeks after the initial infection, the chances of reinfection are still high.

  • Prebiotics: Some doctors advise taking probiotics to promote the growth of beneficial bacteria.
    • These naturally occurring microbes can be found in foods such as yogurt. 
    • Other medical professionals advise against using probiotics because there is no set standard for the specific microbe formations in each food, and a positive effect cannot be guaranteed.
  • Fecal microbiota transplantation: Another person's feces is introduced to the affected colon. It is possible to achieve a healthy balance of gut bacteria by adding a sample of feces containing healthy microflora.
  • Surgery: Surgery is sometimes required to help manage or treat a C diff infection.
    • This is uncommon and usually occurs in the case of bowel perforation. 
    • Surgery is typically considered the last treatment option and is only considered if other forms of treatment and drugs have failed to control the infection.

C diff infections and their complications can be incapacitating, painful, and even fatal. Some infections resolve on their own, but the threat of infection is serious for older individuals.

A few loose stools are not a cause for alarm, but if symptoms persist, a more serious infection may be developing. C diff infection may require tests, such as stool samples or a colonoscopy, to look for pseudomembranous colitis.

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Medically Reviewed on 11/24/2021
References
Image Source: iStock Images

NYU Langone Hospitals. Recovery & Support for Clostridium Difficile Infections. https://nyulangone.org/conditions/clostridium-difficile-infections-in-adults/support#:

Centers for Disease Control and Prevention. FAQs for Clinicians about C. diff. https://www.cdc.gov/cdiff/clinicians/faq.html

WebMD. Clostridium Difficile (C. Diff). https://www.webmd.com/digestive-disorders/clostridium-difficile-colitis