Clostridium Difficile Infection (CDI)

• Clostridium difficile (also known as C. Diff) is a germ bacterium that can cause diarrhea. Most cases of C. diff infection (CDI) occur in patients taking antibiotics.  CDI is the most common cause of diarrhea that occurs during or after use of antibiotics.  Infections can be mild and last only for a short time, or can be severe and recur multiple times. 

The most common symptoms of CDI are:

• Watery diarrhea
• Abdominal (belly) pain/tenderness
• Fever
• Nausea
• Loss of appetite 

Who is most likely to get CDI?

• Anyone who takes an antibiotic is at risk of infection, but children under age one rarely develop disease and the elderly and people with certain medical problems, particularly gastrointestinal, have the greatest chance of getting CDI.  The C. difficile bacterium can form spores which can live outside the human body for a very long time and may be found on things in the environment such as bed linens, bed rails, bathroom fixtures, and medical equipment.  The bacterium and its spores can spread from person-to-person on contaminated equipment and on the hands of doctors, nurses, other healthcare providers and visitors. 

What are hospitals doing to prevent CDI?

To prevent CDI, doctors, nurses, and other healthcare providers:

• Clean their hands with soap and water before and after caring for every patient. This can prevent spores from being passed from one patient to another on their hands.
• Carefully clean and disinfectant hospital rooms and medical equipment.  An EPA-registered hypochlorite-based disinfectant after cleaning is recommended in outbreak or hyperendemic settings.  Bleach is beneficial if there is evidence of ongoing transmission of CDI.  

Use Contact Precautions to prevent C. diff from spreading to other patients. Contact Precautions mean:

• Whenever possible, patients with CDI will have a single room or share a room only with someone else who also has CDI.
• Healthcare providers will put on gloves and wear a gown over their clothing while taking care of patients with CDI.
• Visitors may also be asked to wear a gown and gloves.
• When leaving the room, hospital providers and visitors remove their gown and gloves and clean their hands.
• Only give patients antibiotics when it is necessary

What CDI information is reported to the California Department of Public Health and where can I find that information?

• All California general acute care hospitals are required to report CDI cases that occur following hospitalization so that CDPH can calculate the rates of infection at each hospital and make that information available to the public (Health and Safety Code Section 1288.55).  The latest California hospitals CDI report is available at CDI Report Page. Comparison of the rates of CDI in different hospitals in this report should be avoided because differences may be due to variations in surveillance practices and/or laboratory testing methodology. 

How patients and their advocates can help prevent infections

Team up with your medical providers to prevent CDI

• Ask your provider to clean their hands with soap and water before and after caring for you.
• Ask your provider if any medical equipment was cleaned and disinfected before it was brought into your room.
• Be sure to clean your own hands often, especially after using the bathroom and before eating.
• Only take antibiotics as prescribed by your doctor.