What is it about ?
Diarrhea caused by the bacteria Clostridium difficile Usually occurs during or after treatment with antibiotics.
The bacteria are found in the intestines of healthy people. The “normal” colon has its own population (flora) of bacteria. Treatment with antibiotics also attacks these normal bacteria. This then leaves room for Clostridium difficile to develop. The toxins produced by Clostridium difficile cause intestinal damage and symptoms. All antibiotics can cause diarrhea Clostridium difficile, but it is more common with certain types of antibiotics.
Infection often occurs in homes and hospitals because the people there are weakened and therefore more prone to contamination. Homes and hospitals are also places where antibiotics are administered more frequently. For this reason, some qualify the Clostridium difficile of hospital bacteria.
As bacteria and as spores
the Clostridium difficile has the particularity of appearing in two forms: in the form of bacteria and in the form of spore. The bacteria die on contact with air and alcohol, while the spore is more resistant to it. This is why the contamination prevention measures are so strict. It is very important to wash your hands with soap so as not to spread the bacteria; it is even more important than alcohol disinfection.
What is its frequency?
The number of infections Clostridium difficile increased at the end of the 20th century. This is explained by the increasing use of antibiotics and the appearance of certain more resistant strains. In recent years, the number of infections has remained stable in Belgium. The number of people who die from infection with Clostridium difficile decreases over time.
In 2016 in Belgium, there were around 20 infections with Clostridium difficile per 10,000 hospitalizations. There are big differences from province to province. This infection is more frequent in Wallonia than in Flanders.
How to recognize it?
Symptoms usually start 4 to 9 days after starting antibiotic treatment. Sometimes they appear when the treatment is finished.
- The patient has a stomach ache, has abdominal cramps, and has a fever.
- The diarrhea is profuse, watery.
- Sometimes there is blood and phlegm in the stool
- Rarely, and in severe cases, the intestine is paralyzed, and there is no diarrhea.
How is the diagnosis made?
The doctor will suspect this infection under the circumstances. The diagnosis can only be confirmed by the laboratory which finds the presence of the bacteria or its toxins in a stool sample.
During an endoscopy of the last part of the large intestine (sigmoidoscopy), typical gray-yellow membranes are visible on the intestinal lining. The blood test can only show the presence of factors of inflammation, but not the bacteria itself.
What can you do ?
- Avoid taking antibiotics if it is not necessary. Never take them if your doctor has not prescribed them for you.
- Practice good hand hygiene. Wash your hands with soap and disinfect them before and after each contact with an infected person. Alcohol gel is not enough.
- If necessary, wear an apron or gloves (disposable).
the Clostridium difficile is spread by direct contact. In hospitals and in homes, infected people are treated in a room only.
What can your doctor do?
Examination of stool
If you only have moderate diarrhea and don’t have a fever, stopping the antibiotic may be sufficient. If the diarrhea persists, your doctor will order a stool test. This analysis will confirm the diagnosis. If the doctor suspects an infection with severe symptoms, you will usually be started on treatment before you know the test results.
Medication
Treatment consists of giving an anti-parasite drug (metronidazole). You should take it for about 10 days. If you are seriously ill or if treatment does not work within three days, hospitalization is required to receive antibiotics by infusion and possibly also fluid infusions.
Relapse
One in five people relapse after treatment. In this case, the treatment will be prolonged. If you have a second relapse, you will be given antibiotics in the hospital.
In people who relapse very often, another treatment is sometimes applied which consists of trying to introduce a “good” organism into the large intestine. Medicines (probiotics) can be used to do this, but a fecal transplant is also possible.
Want to know more?
- Hand hygiene – SPF Public health, food chain safety and the environment
- Antibiotics: caution: use only when necessary – Federal Agency for Medicines and Health Products
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