Nearly half a million people in the United States suffer from an intestinal infection called Clostridium difficile each year. Approximately half of those individuals become sick enough to require hospitalization and 10% die.

Most commonly known as C. diff, the bacterial infection can be caused by antibiotics, and ironically, it’s treated with antibiotics.

“C. diff is a bacteria that can exist normally in some people’s gastrointestinal system. However, in some people it can cause severe gastrointestinal disease,” said Hailey Schuckel, director of infection prevention and control at Ogden Regional Medical Center. “C. diff can cause disease when our normal gut flora — these are the good bugs that keep us healthy — is reduced.”

Schuckel said normal flora works in many ways to keep people healthy. One of its functions is to combat C. diff so it doesn’t grow and is only able to exist in a small amount. When normal flora is disrupted, which can be caused by the use of antibiotics, the bacteria is able to grow.

“C. diff, in enough concentration, will then create a toxin that causes disease,” she said. “The C. diff bacteria passes through an infected person’s diarrhea and can spread to others. Anyone can become sick from C. diff, but not everyone who has C. diff will become sick from it.”

Risk factors include being treated with antibiotics, a recent stay in the hospital or a nursing home, being over the age of 65, having a weakened immune system or having had a previous infection with C. diff.

Symptoms can begin a few days after starting an antibiotic and can include watery diarrhea three or more times a day, fever, stomach tenderness and pain, loss of appetite and nausea. It can also cause inflammation of the colon.

“C. diff, unfortunately, is very dangerous and can be deadly,” Schuckel said. It is highly contagious and can pass from one person to another through contamination of the environment or from hands that are contaminated with C. diff.”

The bacteria can also survive for up to five months on surfaces and is resistant to most cleaners and alcohol hand sanitizer, she said. Once you get C. diff, you can get it again. The Centers for Disease Control and Prevention estimates 1 in 6 people who get C. diff will get it again after two to eight weeks. The latest estimates show there were 12,800 deaths associated with C. diff in 2017.

“Fortunately, due to prevention efforts overall, C. diff cases have been on the decline in the U.S. in recent years,” Schuckel said. “That being said, health care systems have been seeing more severe infections associated with C. diff.”

The main complication of the disease is repeat infection as well as severe inflammation of the intestine leading to enlargement of the colon and sepsis.

Schuckel said that while antibiotics are necessary to treat bacterial infections, it’s extremely important to only take them for the appropriate reasons. Antibiotics are not useful in the treatment of viral infections such as colds, flu or COVID-19.

“If you or someone you know is diagnosed with C. diff infection, make sure to keep their home and bathroom clean and use a product that is rated to kill C. diff,” she said. “Bleach is the best product effective at killing C. diff.”

“Overall, there have been great improvements in C. diff prevention and treatment. One of the keys to this has been careful use of antibiotics and the work and tireless efforts of health care professionals,” Schuckel added. “An important factor to preventing C. diff is timely detection and treatment.”

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