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Clostridium Difficile Associated Diarrhoea

What is Clostridium difficile?

Clostridium difficile is one of many types of bacteria which commonly live in the human bowel. Providing a person is healthy, and all the bacteria within the bowel are in balance, Clostridium difficile causes no problems.

How does Clostridium Difficile cause diarrhoea?

If a person is unwell and requires antibiotic treatment the bacterial balance of the bowel may be disturbed. This imbalance allows Clostridium difficile to multiply abnormally and to produce toxins. These toxins cause inflammation within the bowel leading to diarrhoea. The diarrhoea is often severe and other symptoms such as abdominal pain and a high temperature may occur.

Those in the 65 years and over age group are particularly susceptible to Clostridium difficile associated diarrhoea.If Clostridium difficileis suspected a sample of diarrhoea is sent to the laboratory to confirm the diagnosis.

Can Clostridium Difficile be treated?

As Clostridium difficile associated diarrhoea is generally linked with antibiotic treatment, the most effective way to stop the diarrhoea is to stop all antibiotic treatment.

However, this may not be possible if the antibiotics are still required. The doctor may be able to reduce or change the antibiotics, which should help. There are also other medicines (different types of antibiotic), which can be taken in tablet or syrup form, which normalise the bacterial balance of the bowel and so reduce the diarrhoea.

Clostridium difficile diarrhoea may respond quickly to treatment. However, in some patients it can take longer. Sometimes diarrhoea symptoms may resolve but then return because a person has needed a further course of antibiotics. In which case repeat treatment for Clostridium difficile associated diarrhoea would need to be considered.

Can Clostridium Difficile spread from person to person?

A dormant form of the Clostridium difficile bacteria (a spore) is able to survive within the hospital environment particularly in areas such as toilets and commodes. Spores are passed into the environment when a patient who has developed Clostridium difficile toxin has severe diarrhoea. These spores can be picked up on the hands and then swallowednwhen eating and drinking. Swallowing of spores in vulnerable persons may result in Clostridium difficile associated diarrhoea.

How can you prevent Clostridium Difficile from Spreading?

The most important way in which the spread of Clostridium difficile associated diarrhoea can be prevented is by thorough hand washing with soap and water. This action removes any Clostridium difficile spores and washes them away down the sink. 

Good hand washing should be implemented by all patients, visitors and hospital staff and is particularly advised following use of the toilet or toilet care and when leaving a diarrhoea affected area.

Six steps to good hand-washing:

Handwashing Technique
  1. After wetting hands and applying soap, rub hands palm to palm.

  2. Rub right palm over the back of the left hand then, swap hands.
  3. Rub hands together palm to palm with the fingers interlaced.
  4. With clenched fists rub into the palm of the other hand.

  5. Using the right hand, rub around the thumb, then, swap hands.
  6. Rub the tips of the fingers in the opposite palm, then swap hands.

Alcohol gel does not destroy Clostridium difficile spores therefore is not recommended for hand hygiene in the above circumstances.

High standards of environmental cleaning are very important to prevent the spread of Clostridium difficile associated diarrhoea. A specific chlorine disinfectant is used throughout the hospital in all diarrhoea affected areas.

Patients with diarrhoea are allocated their own toilet facilities or commode and if diarrhoea is severe, nursed in a single room. This reduces the spread of Clostridium difficile from the environment.

As antibiotic use is associated with initial cases of Clostridium difficile an antibiotic policy is implemented throughout the trust to guide doctors in appropriate prescribing.

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Questions and Contact

We hope the information on this page has been helpful to you. If you have any questions please talk to the ward staff and/or a member of the Infection Prevention and Control Team. Telephone Infection Control on:

Internal extension: 5785
External: (01604) 545785
between 8.00am - 5.00pm Monday - Friday (24 hour answer machine).

Other Information

For the benefit of our patients, visitors and staff, Northampton General Hospital operates a smoke-free policy. This means smoking is not allowed on the trust site, including all buildings, grounds and car parks. 

Leaflets, information, friendly advice and support on giving up smoking and nicotine replacement therapy are available from the local Stop Smoking Help Line on (01604) 615272, or the free national helpline 0800 169069 and local pharmacies.

Parking spaces are very limited, please arrive early allowing extra time for parking alternatively arrange to be dropped off and collected.

NGV1043 - July 2006

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