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

June 16, 2014

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

Finish your antibiotics course? Maybe not, experts say

July 27, 2017
British disease experts on Thursday suggested doing away with the "incorrect" advice to always finish a course of antibiotics, saying the approach was fuelling the spread of drug resistance.

Co-infection with two common gut pathogens worsens malnutrition in mice

July 27, 2017
Two gut pathogens commonly found in malnourished children combine to worsen malnutrition and impair growth in laboratory mice, according to new research published in PLOS Pathogens.

Phase 3 trial confirms superiority of tocilizumab to steroids for giant cell arteritis

July 26, 2017
A phase 3 clinical trial has confirmed that regular treatment with tocilizumab, an inhibitor of interleukin-6, successfully reduced both symptoms of and the need for high-dose steroid treatment for giant cell arteritis, the ...

A large-scale 'germ trap' solution for hospitals

July 26, 2017
When an infectious airborne illness strikes, some hospitals use negative pressure rooms to isolate and treat patients. These rooms use ventilation controls to keep germ-filled air contained rather than letting it circulate ...

Researchers report new system to study chronic hepatitis B

July 25, 2017
Scientists from Princeton University's Department of Molecular Biology have successfully tested a cell-culture system that will allow researchers to perform laboratory-based studies of long-term hepatitis B virus (HBV) infections. ...

Male hepatitis B patients suffer worse liver ailments, regardless of lifestyle

July 25, 2017
Why men with hepatitis B remain more than twice as likely to develop severe liver disease than women remains a mystery, even after a study led by a recent Drexel University graduate took lifestyle choices and environments ...

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.