Clostridium difficile (CDIF) Infections

Clostridium difficile (CDIF) Infections

Introduction

Clostridium difficile is also known as C. difficile or C.diff. Being a pathogenic bacterium it can cause illness in humans and animals both. It is a species of Gram positive bacteria of the genus Clostridium. It is the cause of severe diarrhea and other intestinal diseases when excessive use of antibiotics disturbs the gut flora by eradicating all competing bacteria. These are anaerobic, spore forming rods.

C. difficile is the most important cause of antibiotic associated diarrhea and pseudomembranous colitis which is a severe inflammation of the colon. Elderly hospitalized patients and people staying in long term care facilities are usually the victims of infections resulting from C. difficile. This usually occurs during or after the use of antibiotic drugs. In developed countries around 80% of these infections occur in patients aged 65 years and above.

Infections developing as a result of C. difficile have started becoming more common with severe symptoms in the developed and developing countries both. These are also very difficult to treat. With the passage of time it was realized that not only hospitalized patients who are on antibiotic drugs but also otherwise healthy people are getting infected with this bacterium. In mild to moderate type of infections, the signs and symptoms subside after stopping the treatment with antibiotics. However patients with severe infections would require different antibiotic medications and additional supportive therapy.

C. difficile is found in the intestinal tract of around 3% of all adults and 66% of children. It may be noted here that healthy individuals are usually not affected by C. difficile. Some antibiotics have been found to disturb the gut flora by altering the balance of good bacteria in the intestinal tract. This provides C. difficile with an opportunity to multiply excessively causing diarrhea and other serious diseases of colon like pseudomembranous colitis.

Most of these infections have been observed in hospital or healthcare environment which implies their association with antibiotic therapy as a substantial number of hospitalized patients use different types of antibiotics to either prevent or control various infections. It has been observed in clinical practice that majority of C. difficile infections recover completely without causing any complications. However a few patients develop long term sequelae and some of them, mostly elderly die. Experts are of the view that by maintaining good hygiene practices in hospital environment, incidence of C. difficile could be minimized.

Discussion

Signs and Symptoms of C. difficile Infections

A symptom is something the patient feels and reports to the doctor whereas sign is something which other people like doctor or nurse observe. As a result of gastrointestinal infection caused by C. difficile, mild to severe diarrhea, blood stained stools, fever and mild abdominal cramps and tenderness can be reported. These signs and symptoms generally develop as a result of inflammatory process in the lining of the large intestine or colon causing colitis. Peritonitis, septicemia and perforation of colon may also occur rarely in certain untreated cases. Signs and symptoms in more severe cases would ...