C. difficile epidemic should concern not only hospital patients but people at home

June 16, 2014, Case Western Reserve University

Without proper infection prevention in hospitals, and now homes, the Clostridium difficile bacteria poses a major health threat, cautions a Case Western Reserve University infection control researcher.

While mainly a concern in hospitals, cases of the C. difficile infection (or C. diff) are on the rise in the community, according to the Centers for Disease Control and Prevention that has seen increased reports of the infected people who have had no contact with hospital patients with the infection. The CDC reported 7.6 people out of 100,000 who had no contact with people with C. diff were getting sick with the illness.

It particularly infects healthy people, and particularly pregnant women, said Irena Kenneley, a Case Western Reserve clinical nurse specialist in and associate professor at the Frances Payne Bolton School of Nursing.

Symptoms of C. diff include continual bouts of diarrhea, severe cramps, swollen stomach and intestinal irritation.

Potentially, the bacteria's toxins can cause ulcers and eventually eat through intestine walls, which allows infection to enter the blood.

Kenneley's American Journal of Nursing article, "Clostridium difficile Infection Is on the Rise," focuses on evidence-based steps recommended by the CDC that nurses and other , including those who prepare and deliver food, clean facilities or make deliveries, can take to confine the bacteria in hospitals and other settings where someone shows symptoms of the infection. And similar precautions apply at home.

"The article delivers practical advice to nurses and nurse practitioners on and control activities in any setting," Kenneley said.

Based on CDC guidelines, she recommends:

  • Isolating the patient (or, if possible, the person at home) when symptoms appear;
  • Appropriate and timely lab testing to determine the type of bacteria present;
  • Treating with appropriate antibiotics;
  • Cleaning thoroughly (using bleach is best);
  • Washing hands to stop the spread of further infections.

That last step, washing hands, is critical for hospital workers, family members and other visitors who have encountered someone with C. diff or is suspected to have contracted the bacteria. It can take up to 96 hours to confirm a C. diff diagnosis. Because of the wait for a diagnosis, isolation of the patient is key—a practice similar to hospital protocol for patients with suspected tuberculosis.

Kenneley said these bacteria that can live as hibernating spores up to 100 years on surfaces until conditions are right to proliferate. The stomach and intestines offer that environment, once ingested.

Particularly at risk are people with compromised immune systems (HIV and transplant patients), those who are aging, recovering from gastrointestinal surgeries or are on antibiotics for more than three days to treat other illnesses.

C. diff has proliferated through use of broad-spectrum antibiotics that wipe out the healthy bacteria. A few antibiotics, such as vancomycin and metronidazole, have some success treating the , she said.

Poor hand-washing practices allow spores to travel between patients and other surfaces. Hand-washing must occur multiple times during patient care.

Kenneley recommends washing hands before entering a room, any time the hands touch a new surface in the room, and when exiting. And soap is more effective than alcohol-based hand sanitizers or wipes that do not destroy spores, she said.

Although hospitals clean rooms daily and after a patient leaves, some spores may still survive, Kenneley said, which is why the key to prevention is hand-washing.

Explore further: Combating the C. diff terrorists on the loose in hospitals

Related Stories

Combating the C. diff terrorists on the loose in hospitals

May 19, 2011
Just like intelligence agents watching for the real terrorists threatening to attack, monitoring healthcare worker adherence to mandatory hand-washing protocols via hand-washing squads in hospitals can go a long way to stop ...

Infectious diarrhea germs stick to healthcare worker hands

December 23, 2013
A new study finds nearly one in four healthcare workers' hands were contaminated with Clostridium difficile spores after routine care of patients infected with the bacteria. The study was published in the January issue of ...

Researcher surveys infection control practices for home patients

June 25, 2012
A healthy boy was infected with antibiotic-resistant bacterium that was traced to his mother's nurse's bag left in the family's car after his mother's home healthcare visit to a patient with the same infection. Although the ...

Researchers identify components in C. diff that may lead to better treatment

January 30, 2014
Rhode Island Hospital researchers have identified components in Clostridium difficile (C. diff) that may lead to new diagnostic tools, and ultimately more timely and effective treatment for this often fatal infection. C. ...

C. diff infection risk rises with antihistamine use to treat stomach acid, study finds

March 27, 2013
Patients receiving antihistamines to suppress stomach acid are at greater risk of infection from Clostridium difficile, or C. diff, a common cause of diarrhea, particularly in health care settings, Mayo Clinic researchers ...

Study reports increasing incidence of Clostridium difficile infection

May 21, 2012
A study presented by Mayo Clinic researchers during Digestive Disease Week 2012 provides clear evidence that the number of people contracting the hard-to-control and treat bacterial infection Clostridium difficile (C. difficile ...

Recommended for you

Study ends debate over role of steroids in treating septic shock

January 19, 2018
The results from the largest ever study of septic shock could improve treatment for critically ill patients and save health systems worldwide hundreds of millions of dollars each year.

New approach could help curtail hospitalizations due to influenza infection

January 18, 2018
More than 700,000 Americans were hospitalized due to illnesses associated with the seasonal flu during the 2014-15 flu season, according to federal estimates. A radical new approach to vaccine development at UCLA may help ...

Zika virus damages placenta, which may explain malformed babies

January 18, 2018
Though the Zika virus is widely known for a recent outbreak that caused children to be born with microencephaly, or having a small head, and other malformations, scientists have struggled to explain how the virus affects ...

Certain flu virus mutations may compensate for fitness costs of other mutations

January 18, 2018
Seasonal flu viruses continually undergo mutations that help them evade the human immune system, but some of these mutations can reduce a virus's potency. According to new research published in PLOS Pathogens, certain mutations ...

Study reveals how MRSA infection compromises lymphatic function

January 17, 2018
Infections of the skin or other soft tissues with the hard-to-treat MRSA (methicillin-resistant Staphylococcus aureus) bacteria appear to permanently compromise the lymphatic system, which is crucial to immune system function. ...

Fresh approach to tuberculosis vaccine offers better protection

January 17, 2018
A unique platform that resulted in a promising HIV vaccine has also led to a new, highly effective vaccine against tuberculosis that is moving toward testing in humans.

0 comments

Please sign in to add a comment. Registration is free, and takes less than a minute. Read more

Click here to reset your password.
Sign in to get notified via email when new comments are made.