Clostridioides difficile infection (CDI)

What is Clostridioides difficile?

Clostridioides difficile (C.diff) is a germ that often lives in the gut of healthy people.  It does not always cause illness, however some people can develop a C.diff infection (CDI). 

CDI can occur when there is a change to the normal bacteria that live in the gut, such as when someone has taken antibiotics. This can allow the C.diff germs to multiply and produce toxins. These toxins cause inflammation of the gut lining which can cause symptoms such as diarrhoea. 

Who is at risk of getting CDI?

Risk factors for developing CDI include: 

• antibiotic use
• older age 
• extended stays at a health care or residential aged care facility 
• a weakened immune system, such as those receiving chemotherapy
• gastrointestinal surgery
• sharing a hospital room or bathroom with someone who has C.diff

What are the symptoms of CDI?

Symptoms of CDI may include watery diarrhoea, fever, abdominal pain, loss of appetite and nausea.  While in some people, symptoms can be mild, severe cases can result in serious damage to the bowel.

How is CDI diagnosed and treated? 

CDI is diagnosed by testing a sample of your poo for C.diff toxins. 

Your doctor will arrange your CDI treatment - usually, a course of oral antibiotics. In some people, CDI can be difficult to treat and may return, so close medical follow-up is important after CDI has been diagnosed.

Can I spread CDI to others?

Yes, C. diff can be spread to other people.

It can spread through direct skin contact, particularly by the hands. It can also be spread through indirect contact, when surfaces in the environment become contaminated. C.diff can live on surfaces for a long time. When someone touches a surface that has been contaminated with an infected person’s poo (such as commodes, toilet seats, sinks) the germs can get on their hands. If a person does not clean their hands, this germ can accidentally enter a person’s mouth and cause infection.

C.diff can also be spread on the hands of a healthcare worker or shared equipment. Never be afraid to ask a healthcare worker if they have washed their hands or equipment before touching you!

Will having CDI affect my hospital stay?

If you have CDI, its important for staff to stop it spreading to other patients. 

They do this by:

• usually, caring for you in a single room
• cleaning their hands after touching you or your surroundings
• wearing gloves and gowns/aprons when they come into your room and removing them when they leave your room; and
• cleaning your room regularly.

What can I do to stop the spread of CDI?

The most simple and effective way you can stop the spread of C.diff is to wash your hands with soap and water:

• before handling food or drinks 
• after going to the toilet
• after handling dirty washing
• when leaving your room.

You should also follow any instructions from your nurse or doctor.

Can I have visitors while I am in hospital?

There are usually no restrictions on visitors but please check with the nursing staff if you or your visitors have any concerns.

When visiting someone with CDI, extra precautions may be required including:

• Washing your hands with soap and water or alcohol-based hand rub before and after they visit you
• Wearing personal protective equipment, such as gowns or gloves, as advised by nursing or medical staff, before entering your room 

What about when I go home?

You should continue to clean your hands regularly when you go home to prevent the spread of C.diff to others.

It is also important to keep your environment clean, particularly surfaces that are frequently touched including the bathroom and toilet.

Further questions?

Please ask your doctor or nurse if you have any more questions about C diff.