{"id":16192,"date":"2023-03-06T21:13:57","date_gmt":"2023-03-06T21:13:57","guid":{"rendered":"https:\/\/cdhf.staging.not4prod.com\/?p=16192"},"modified":"2024-11-18T14:53:16","modified_gmt":"2024-11-18T14:53:16","slug":"clostridium-difficile","status":"publish","type":"post","link":"https:\/\/cdhf.ca\/en\/clostridium-difficile\/","title":{"rendered":"Clostridium Difficile"},"content":{"rendered":"\n

Have you heard of Clostridioides difficile<\/em>? It is a leading cause of infectious diarrhea<\/a> in hospitals and long-term care facilities in Canada (Pereira et al., 2020). Since the 2000s, there has been a dramatic increase in the number and severity of Clostridioides difficile<\/em> infection cases across the globe (American College of Gastroenterology, 2021); according to research approximately 41% of these infections are acquired in the community (Mada & Alam, 2022).<\/p>\n\n\n\n

So, what is <\/strong>Clostridioides difficile<\/strong><\/em>?<\/strong><\/h2>\n\n\n\n

Clostridioides difficile, more commonly known as C. diff for short, is <\/em>a type of bacteria that causes irritation and swelling of the colon (colitis) leading to gastrointestinal issues such as nausea, vomiting, abdominal pain and diarrhea (HealthLink BC, n.d).<\/p>\n\n\n\n

C. diff<\/em> lives in the intestines of 1-3% of people (HealthLink BC, n.d). In fact, it is considered a part of the natural gut flora, which means that it lives harmlessly in the large bowel along with other types of \u201cgood\u201d bacteria. These bacteria function to keep the bowel healthy. However, if the natural balance of the gut bacteria is altered, C. diff <\/em>can flourish and release toxins (poisons). This damages the intestine causing diarrhea and other health problems (HealthLink BC, n.d.; American College of Gastroenterology, 2021).<\/p>\n\n\n\n

How is C. diff <\/em>transmitted? <\/strong><\/h3>\n\n\n\n

C. diff<\/em> is transmitted through the fecal-oral route. It is found in feces of infected individuals and transfers through contact with contaminated hands or surfaces.  It is also contagious, spreading from person to person. Furthermore, it can persist on surfaces for a long time as inactivated or dormant spores (Centers for Disease Control and Prevention [CDC], 2021).  <\/p>\n\n\n\n

What puts you at risk of C. diff infection?<\/em><\/strong><\/h2>\n\n\n\n

C. diff <\/em>can affect anyone, but most cases are associated with certain high-risks antibiotics such as clindamycin, quinolones and cephalosporins (American College of Gastroenterology, 2021). When used in high doses or for a prolonged period, they can alter the normal levels of the bacteria giving C. diff <\/em>an opportunity to thrive (Public Health Agency of Canada, 2014).<\/p>\n\n\n\n

Other factors that can put you at risk include:<\/p>\n\n\n\n

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  1. Medicines that reduce stomach acid, such as Nexium, Prevacid, or Losec<\/li>\n\n\n\n
  2. Advanced age (65 and older)<\/li>\n\n\n\n
  3. Weakened immune systems ex. people living with HIV\/AIDS, cancer or organ transplant<\/li>\n\n\n\n
  4. Pre-existing bowel conditions such as Inflammatory Bowel Disease (IBD)<\/li>\n\n\n\n
  5. Staying in a hospital or long-term care facilities<\/li>\n\n\n\n
  6. Previous C. diff<\/em> infection (American College of Gastroenterology, 2021, familydoctor.org, 2020)<\/li>\n<\/ol>\n\n\n\n

    What are the symptoms of <\/strong><\/em>C. diff?<\/em><\/strong> <\/em><\/strong><\/h2>\n\n\n\n

    Diarrhea is the most commonly reported symptom of C. diff. However, symptoms <\/em>can range from mild to severe. Mild symptoms include 3 or more daily episodes of diarrhea for a few days and belly pain\/tenderness. Severe symptoms can range from watery diarrhea with mucus or blood to fever, nausea, vomiting, belly cramps, bloating, loss of appetite and dehydration. Sometimes it can even progress to life-threatening colon inflammation (American College of Gastroenterology, 2021; familydoctor.org, 2020).  <\/p>\n\n\n\n

    What happens if I have symptoms? <\/em><\/strong><\/h3>\n\n\n\n

    Speak to your <\/em>doctor. If C. diff<\/em> infection is suspected, a stool test may be ordered. Treatment depends on the severity of symptoms. If the test is positive, your doctor will prescribe an appropriate antibiotic to treat the infection. Your doctor may also recommend stopping the antibiotic that led to the infection in the first place. However, this may not always be possible as some individuals require long-term antibiotics for underlying health conditions. Depending on the severity of symptoms, you may also need to be hospitalized. Sometimes complications may arise such as toxic megacolon, a condition in which the large bowel is dilated and at risk of perforation. In such cases, surgery might be considered to remove the affected portion of the intestine (American College of Gastroenterology, 2021; HealthLink BC, n.d.). By working together with your doctor, you can determine what the next steps, best suited, for you are.<\/p>\n\n\n\n

    Are there any steps I can take to prevent CDI?<\/strong><\/h2>\n\n\n\n

    There are several things you can do to prevent yourself from developing or spreading a C. diff<\/em> infection.<\/p>\n\n\n\n

    These include strategies such a:<\/p>\n\n\n\n

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    1. Be cautious about hygiene. Wash your hands regularly with soap and warm water for at least 20 seconds. Remember <\/strong>Clostridium Difficile is contagious.<\/li>\n\n\n\n
    2. Don\u2019t take antibiotics unnecessarily<\/u>. <\/strong>When you take antibiotics, the \u201cgood\u201d bacteria in your intestines can also be killed, which may cause C. diff <\/em>to grow out of control. Limit the use of antibiotics to bacterial infections, as prescribed by your doctor.<\/li>\n\n\n\n
    3. Keep high-use surfaces or areas clean.<\/strong> Periodically clean these areas, especially the kitchen and bathroom. C. diff <\/em>spores are hardy; be sure to use products containing chlorine bleach because it is an effective disinfectant against C. diff (<\/em>familydoctor.org, 2020)<\/em>.<\/li>\n<\/ol>\n\n\n\n

      Another way is through the use of probiotics<\/strong>.<\/p>\n\n\n\n

      The World Health Organization (WHO) defines probiotics as \u201clive microorganisms which when administered in adequate amounts confer a health benefit on the host (Hill et al., 2014). In simple terms, probiotics are\u202f\u201cgood bugs\u201d\u202for\u202f\u201cgood microbes\u201d\u202fthat improve certain aspects of our health. They are available as dietary supplements and can also be found in foods such as certain kinds of yogurt.<\/p>\n\n\n\n

      It\u2019s important that you talk with a health care professional \u2013 your doctor, pharmacist, or dietitian – first before taking a probiotic supplement, to ensure you have a proper diagnosis or know why you are taking it. Together, you can select an appropriate probiotic that is the most suitable for you because probiotics aren\u2019t all the same, and have different health benefits. One such probiotic is Florastor<\/strong><\/a>\u00ae<\/strong> which contains Saccharomyces boulardii CNCM I-745 <\/em>(S. Boulardii<\/em>). It is a type of yeast well known and recommended to reduce the incidence of antibiotic associated diarrhea to support a healthy digestive system by promoting helpful gut flora and strengthening the immune system (Bowman, 2017).<\/p>\n\n\n\n

      Research into S. Boulardii <\/em>dates back to the 1990s. Recent studies have determined that S. Boulardii<\/em> not only reduces the risk of antibiotic associated diarrhea but also lowers the recurrence rate of C. diff <\/em>infection. In fact, a 2017 systematic review and meta-analysis concluded that S. Boulardii<\/em> reduced the risk of antibiotic associated diarrhea caused by C. Diff,<\/em> while a systematic review and meta-analysis published out of The American Journal of Gastroenterology confirmed the efficacy of S. Boulardii<\/em> in reducing the recurrence rate of C. diff<\/em> infections (Goldenberg, 2017; Tariq et al., 2021).<\/p>\n\n\n\n

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