Difficile clostridium (c. diff)

Abdomen | Gastroenterology | Difficile clostridium (c. diff) (Disease)


Clostridium difficile (C. difficile) is a bacterium that is related to the bacterium that cause tetanus and botulism. The C. difficile bacterium has two forms, an active, infectious form that cannot survive in the environment for prolonged periods, and a nonactive, noninfectious form, called a spore, that can survive in the environment for prolonged periods. Although spores cannot cause infection directly, when they are ingested they transform into the active, infectious form.

A person with pseudomembranous colitis has severe inflammation of the colon, caused by treatment with antibiotics. The antibiotics kill the bacteria that normally live in the colon. This leads to an overgrowth of bacteria, called Clostridium difficile, which invade the wall of the colon and cause inflammation. About 1 out of every 15,000 people treated with an antibiotic develop pseudomembranous colitis.

Causes and Risk factors

In a very small percentage of the adult population, C. difficile bacteria naturally reside in the gut. Other people accidentally ingest spores of the bacteria while they are patients in a hospital, nursing home, or similar facility.

When the bacteria are in a colon in which the normal gut flora has been destroyed (usually after a broad-spectrum antibiotic such as clindamycin has been used), the gut becomes overrun with C. difficile. This overpopulation is harmful because the bacteria release toxins that can cause bloating and diarrhea, with abdominal pain, which may become severe.

C. difficile infections are the most common cause of pseudomembranous colitis, and in rare cases this can progress to toxic megacolon, which can be life-threatening.

Diagnosis and Treatment

The first step in treating C. difficile is to stop taking the antibiotic that triggered the infection, when possible. For mild illness, this may be enough to relieve symptoms. But many people require further treatment.


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