Clostridium difficile (often called C. difficile or C. diff) is a Gram-positive, rod-shaped, anaerobic bacterium that forms spores. It lives in the large intestine of a small proportion of healthy people without causing harm, because it is kept in check by competition from the huge numbers of other, harmless bacteria in the gut.How infection develops. Antibiotics, especially broad-spectrum antibiotics taken over a long period, kill many of the harmless gut bacteria. C. difficile is naturally resistant to many antibiotics, so it survives. With its competitors gone, it multiplies rapidly and secretes exotoxins (toxins A and B). These damage the epithelial cells lining the colon, causing inflammation, watery diarrhoea, abdominal pain and fever. In severe cases the colon becomes badly inflamed (colitis), which can be fatal, especially in elderly patients.Why it spreads in hospitals. Infected people release large numbers of spores in their faeces. The spores:
• are resistant to heat, drying and many disinfectants;
• survive for months on surfaces such as bed rails, toilets and door handles;
• are not killed by alcohol hand gels.
Spores are swallowed after being picked up on hands, then germinate in the gut.Control. Hands must be washed with soap and water, which physically removes spores. Surfaces are cleaned with chlorine-based disinfectants, infected patients are isolated, and gloves and aprons are worn. Reducing the use of broad-spectrum antibiotics is one of the most effective ways of preventing C. difficile infection.
• are resistant to heat, drying and many disinfectants;
• survive for months on surfaces such as bed rails, toilets and door handles;
• are not killed by alcohol hand gels.
Spores are swallowed after being picked up on hands, then germinate in the gut.Control. Hands must be washed with soap and water, which physically removes spores. Surfaces are cleaned with chlorine-based disinfectants, infected patients are isolated, and gloves and aprons are worn. Reducing the use of broad-spectrum antibiotics is one of the most effective ways of preventing C. difficile infection.