Clostridium difficile (klos-TRID-e-um dif-uh-SEEL), also known as Clostridioides difficile and often referred to as C. difficile or C. diff, is a bacterium that can cause symptoms ranging from diarrhea to life-threatening inflammation range of the large intestine.

C. difficile disease most commonly affects elderly people in hospitals or long-term care facilities and usually occurs after using antibiotics. However, studies show an increasing rate of C. difficile infection in people who are traditionally classified as not at risk, such as young and healthy people who have not used antibiotics and have not been to a health facility.

Approximately half a million people develop C. difficile each year in the United States, and in recent years C. difficile infections have become more common, more serious, and more difficult to treat. Recurring C. difficile infections are also increasing.

Some people carry C. difficile bacteria in their intestines but never get sick, although they can rarely spread the infection. Signs and symptoms usually develop within five to 10 days of starting antibiotic treatment, but they can appear as early as the first day or up to two months later.

Mild to moderate infection
The most common signs and symptoms of mild to moderate C. difficile infection are:

Watery diarrhea three or more times a day for two or more days
Slight abdominal cramps and tenderness

The reasons
Colon and rectum
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C. difficile bacteria are found throughout the environment – in soil, air, water, human and animal feces, and in foods such as processed meat. A small number of healthy people naturally carry the bacteria in the colon and do not experience the harmful effects of infection.

C. difficile spores enter the feces and spread to food, surfaces, and objects if infected people do not wash their hands thoroughly. These spores can linger in a room for weeks or months. If you touch a surface contaminated with C. difficile spores, you can inadvertently ingest the bacteria.

Risk factors
Although people who are not aware of any risk factors will develop C. difficile, certain factors increase the risk.

Take antibiotics or other medications
Your gut contains around 100 trillion bacterial cells and up to 2,000 different types of bacteria, many of which protect your body from infection. When you take an antibiotic to treat an infection, these drugs tend to destroy some of the normal and helpful bacteria in addition to the bacteria that are causing the infection. Without enough healthy bacteria to control it, C. difficile can quickly get out of hand. The antibiotics that most commonly cause C. difficile infections include:


To prevent the spread of C. difficile, hospitals and other healthcare facilities follow strict infection control guidelines. If you have a friend or family member in a hospital or nursing home, don’t be afraid to remind caregivers to follow recommended precautions.

Preventive measures include:

Avoid unnecessary use of antibiotics. Antibiotics are sometimes prescribed for viral diseases that these drugs do not help. For simple illnesses, wait and see. If you need an antibiotic, ask your doctor to prescribe an antibiotic that has a narrow range and that you take as soon as possible.
Wash your hands. Health workers should practice good hand hygiene before and after treating anyone in their care. In the event of a C. difficile outbreak, using soap and warm water is a better choice for hand hygiene as alcohol-based hand sanitizers are not effective at killing C. difficile spores. Visitors should wash their hands with soap and lukewarm water before and after leaving the room or using the bathroom.
Contact precautions. People admitted to hospital for C. difficile have a private room or share a room with someone with the same illness. Hospital staff and visitors wear disposable gloves and isolation gowns when they are there.

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