(C. difficile, C. diff)
Clostridium Difficile (C. diff) Colitis Overview
Clostridium difficile (or C. difficile, C. diff) colitis is a common infection of the colon
that is typically associated with the use of antibiotics. It is, therefore, also
called antibiotic-associated colitis. Another common name for this condition is
Clostridium is a family of bacteria containing several members. Some of the
other well known bacteria in this group include Clostridium botulinum and
Clostridium tetani, which are the causes of botulism and tetanus, respectively.
There are typically two forms of Clostridium difficile; one is the inactive
or non-infectious form, called the spore, and the other is the active and
infectious form. The spore form can survive in the environment for a long time,
whereas the active form cannot.
Clostridium difficile colonize the intestinal tract by the oral route
following the disruption of the balance of normal colonic bacteria (normal flora), which is
usually due to the use of antibiotics. Although C. diff spores may reside in the
active form in the colon of some individuals (carrier state), they can also be
ingested in this form (fecal-oral transmission).
After being shed in the stool, C. diff may be found residing in many places,
especially in hospitals, nursing homes, and other health care facilities.
The common locations
of the C. diff include:
- bathroom floors,
- diaper pails,
- jewelry (rings),
- infant's rooms,
- toilet seats, and
- other objects commonly used by patients and health care
During the last 10 years, C. difficile infections have been observed to be more frequent, severe, and resistant to standard therapy. This is linked to the emergence of new strains of C. difficile and continued increase use of antibiotics. Large out breaks of C. difficile infections have been observed throughout North America and Europe. Not only are the incidence of these infections increasing in the hospital setting but they are also occurring in the community setting (community acquired infections ).
A report in October 2012 found C. difficile present in hospital food
at one facility.
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