Clostridium difficile is a bacterium that occurs around the world. It is found in the environment and also occurs in the intestines of healthy persons and animals. Clostridium difficile bacteria may, however, become a problem if extended taking of antibiotics has changed or even destroyed the usual intestinal flora. Clostridium difficile bacteria may excrete toxins that may cause intestinal inflammation with severe diarrhoea in certain cases. Clostridium difficile disease occurs most often in hospital patients.
The pathogens are excreted in the stool. They are highly contagious. Even a small amount of the germs is sufficient for contagion. Not everyone will fall sick, however.
Person-to-person
Infection usually happens person-to-person by contact infection. Clostridium difficile bacteria are passed on in minute traces of faecal matter from patients to others via the hands. From the hand, the pathogens enter the mouth.
Via contaminated objects
In their resistant permanent forms, the spores, the bacteria may also survive outside of the gastrointestinal tract, and can sometimes do so for years. Therefore, they can also be transmitted via contaminated objects and areas, such as toilets, door handles, handles or hand rails.
The intestinal infection shows itself in the form of sudden, watery diarrhoea, nausea, stomach ache and fever. The diarrhoea has a typical rotting smell and can be bloody. In some cases, the disease will heal on its own.
Possible complications are ileus, acute expansion of the large intestine, a hole or tear in the intestinal wall or blood poisoning (sepsis).
A person’s intestinal flora can have the Clostridium difficile bacteria without causing any complaints. The time between antibiotics therapy and the occurrence of symptoms usually is only a few days. In rare cases, there may be several weeks or even months before the symptoms appear.
The danger of infection is highest during the acute illness. Patients may excrete the pathogens in their stool for some time after the symptoms end.
Clostridium infections most frequently happen in hospital patients. Older persons with underlying medical conditions as well as persons who have taken antibiotics in the last two months are particularly at risk. Older persons and persons with weakened immune systems also are at an increased risk of severe progress. Relapses after the end of the symptoms are more likely among older persons. The bacteria can be documented in 20% to 40% of all hospital patients. However, most show no complaints.
Observe the following precautionary measures:
1. Hand hygiene
Generally: Wash your hands at regular intervals! Wash your hands thoroughly with soap and water after going to the toilet and before preparing any food or eating! The spores are washed off with water and soap as well. Dry your hands carefully using a clean cloth after washing. Patients and their household members should observe particularly thorough hand hygiene.
2. Other hygiene procedures
Your local health authority can provide you with further advice. Since contagious diarrhoea is subject to the rules of the German Prevention of Infection Act, they will also have the latest information and be very experienced in dealing with the disease.
More (specialist) information is also available online from the Robert Koch Institute (www.rki.de/clostridium).
For more information about how hygiene can guard against infection, please visit the Federal Centre for Health Education website (www.infektionsschutz.de).