Are You at Risk of Getting a C. difficile Infection?

Published on Dec 02, 2019
Authored by Pfizer Medical Team

A growing health concern in the US, C. diff (short for Clostridioides difficile), is a bacterium that can cause symptoms from diarrhea to serious intestinal infections, such as colitis. Every year in the US, there are approximately 450,000 cases of C. diff and 29,000 deaths associated with the infection, leading the Centers for Disease Control and Prevention to designate C. diff as an “urgent threat.” Read on to learn more about C. diff, the risks and symptoms, and how you may help prevent and treat it.

What is C. diff?

C. diff is a bacterium that, when in the form of a spore, can live on environmental surfaces for prolonged periods and are resistant to killing by common disinfectants. C. diff can spread via the fecal-oral route. What this means is that contaminated particles from feces from a person with C. diff are somehow ingested by another person. This may happen by touching a person, surface, object, or food contaminated with the bacteria and not washing your hands before you eat something.

However, while many people have the bacteria in their intestines, they all don’t become sick. This may be due to a couple of reasons:

  1. The “good” bacteria in your gut keep C. diff in check.
  2. Not all strains of C. diff produce the toxins that cause symptoms.

Who’s at risk?

Some people may be at higher risk of getting a C. diff infection than others. Risk factors may include:

  • Prior use of antibiotics (although antibiotics are helpful in treating infections, they can wipe out or decrease the number of “good” bacteria in the gut. This disrupts the healthy balance of good and bad bacteria).
  • Gastrointestinal (GI) surgery.
  • An extended stay in a healthcare setting.
  • An underlying illness.
  • A weakened immune system.
  • Use of medicines that block the production of stomach acid (proton pump inhibitors or H2-blockers).
  • A previous C. diff infection.
  • Age (65 years of age and older).

While some people have an increased risk for a C. diff infection, anyone can get it including young, healthy individuals who have not been in the hospital.

“My doctors asked me a bunch of questions: Was I in a hospital? Was I around older people? Had I been outside of the country or on antibiotics? I wasn’t exposed to any of those things,” says Danielle, 31, speaking from her own personal experience battling C. diff. “I think it’s one of those things that people do really need to be aware of—that C. diff really can affect anyone, in any place, at any time.”

What are the signs and symptoms?

Symptoms may include:

  • Diarrhea.
  • Fever.
  • Stomach pain or tenderness.
  • Loss of appetite.
  • Nausea.

In rare cases, more severe complications can occur such as serious intestinal conditions, like enlargement of the large intestine (toxic megacolon); blood stream infections (sepsis); and even death.

If you experience symptoms of a C. diff infection, be sure to talk with your healthcare provider.

Kathy, 75, who had eight C. diff infections over four years describes her story: “My experience with C. difficile was agonizing. I felt so isolated, not only because of the symptoms like diarrhea and dehydration, but also because I had such discomfort that even leaving my house was a challenge.”

How is C. diff diagnosed and treated?

In order to make a diagnosis, your healthcare provider will consider your symptoms, and may recommend a few tests, such as:

  • A stool test.
  • Colonoscopy.
  • A CT scan or X-ray.

If you develop a C. diff infection as a result of taking an antibiotic for another illness, your healthcare provider may ask you to stop taking it. C. diff infections are usually treated with antibiotics that specifically kill C. diff bacteria. It is important you take the prescribed antibiotic as directed. If antibiotics fail, more interventions may be recommended.

How can you help prevent C. diff infections?

C. diff can live for a long time on surfaces such as toilet seats, phones, and doorknobs. Washing your hands with soap and water, especially after using the restroom or visiting a healthcare setting, as well as using bleach-based disinfectants to clean surfaces likely to be colonized with C. diff, can go a long way in helping you avoid the bacteria.

Are You at Risk of Getting a C. difficile Infection


If you have a C. diff infection, you may be at risk of getting it again. In fact, despite effective treatment, as many as 1 in 5 people treated for C. diff will experience a recurrence of the infection. So, it is very important to follow these tips to help prevent getting it again and spreading it to others.

Catia Ferreira, PhD, is in Global Medical Affairs at Pfizer Inc.

References

  • 1. Centers for Disease Control and Prevention. Clostridioides difficile Infection. Accessed August 14, 2019.
  • 2. Centers for Disease Control and Prevention. What is C. diff? Accessed July 22, 2019.
  • 3. Centers for Disease Control and Prevention. Your Risk of C. diff. Accessed July 22, 2019.
  • 4. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. N Engl J Med. 2015;372(9):825-834.
  • 5. Centers for Disease Control and Prevention. Prevent the Spread of C. diff. Accessed July 22, 2019.
  • 6. Familydoctor.org. Clostridium difficile (C. diff.) Infection. Accessed July 22, 2019.
  • 7. Depestel DD, Aronoff DM. Epidemiology of Clostridium difficile (C. diff.) Infection. J Pharm Pract. 2013;26(5):464-475.
  • 8. Centers for Disease Control and Prevention. FAQs for Clinicians about C. diff. Accessed September 25, 2019.
  • 9. Asempa TE, Nicolau DP. Clostridium difficile infection in the elderly: an update on management. Clin Interv Aging. 2017;12:1799-1809.
  • 10. Lamendella R, Wright JR, Hackman J, et al. Antibiotic treatments for Clostridium difficile infection are associated with distinct bacterial and fungal community structures. mSphere. 2018;3(1). pii: e00572-17. doi: 10.1128/mSphere.00572-17.
  • 11. Harvard Health Publishing. Clostridium difficile: An Intestinal Infection on the Rise. Accessed July 22, 2019.
  • 12. Cole SA, Stahl TJ. Persistent and recurrent Clostridium difficile colitis. Clin Colon Rectal Surg. 2015;28(2):65-69. Accessed July 22, 2019.
  • 13. Centers for Disease Control and Prevention. Life After C. diff. Accessed July 22, 2019.
  • 14. American College of Physicians. Clostridium difficile (C. diff). Accessed September 26, 2019.
  • 15. Centers for Disease Control and Prevention. Nearly half a million Americans suffered from Clostridium difficile infections in a single year. Accessed September 27, 2019.
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