Answering your questions about C. difficile

What is Clostridium difficile (C. diff)?
Who gets C. diff?
How is C. diff treated?
How is C. diff spread?
How to prevent spread of C. diff
What should I do at home?
What are the risk factors for CDI?
How will my doctor know if I have this?
How will you treat me if I get this infection?
What happens if I get a CDI while I’m a patient in the hospital?

St. Joseph's Public Reporting

What information is being reported on our website?
How are the rates calculated?
How frequently is St. Joseph's reporting this information?

Answering your questions about Clostridium Difficile Associated Diarrhea (CDAD)

What is Clostridium difficile (C. diff)?

Clostridium difficile is one of many types of bacteria that can be found in feces (bowel movement).  C. diff occurs when antibiotics kill your good bowel bacteria and allow the C. diff to grow.  C. diff produces toxins that can damage the bowel and may cause diarrhea.  It can be mild, severe possibly requiring surgery and in extreme cases C. diff may cause death. 

C. diff is the most common cause of infectious diarrhea in hospital.  The main symptoms of C. diff disease are:

• Watery diarrhea
• Fever
• Abdominal pain or tenderness.

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Who gets C. diff?

C. diff disease usually occurs during or after the use of antibiotics.  Old age, presence of other serious illnesses and poor overall health may increase the risk of severe disease.

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How is C. diff treated?

Treatment depends on how sick you are.  People with mild symptoms may not need treatment. For more severe disease, antibiotics are required.

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How is C. diff spread?

The bacteria in the stool can contaminate surfaces such as toilets, handles, bedpans or commode chairs.  When we touch these items with our hands they become contaminated and if we then touch our mouth without washing our hands, we can become infected.  Our soiled hands can also spread the bacteria to other surfaces.

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How to prevent spread of C. diff

Cleaning hands is the most important way for everyone to prevent the spread of C. diff.  Everyone MUST clean their hands when leaving your room.

If you have C diff disease, you will be put in a single room with your own washroom to prevent spread of the disease.  Your activities outside the room may be restricted.  All heath care staff providing direct care to you must wear a gown and gloves.  Family or visitors providing care to you must also wear gown and gloves to prevent spread of the disease. 

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What should I do at home?

Healthy people like your family and friends who are not taking antibiotics are at very low risk of getting C. diff disease.

Hand hygiene
Wash your hands for at least 15 seconds:

• After using the toilet
• After touching dirty surfaces
• Before eating
• Before preparing meals

Cleaning the house
Use an all purpose household cleaner.  Follow the directions on the label, and:

• Remove visible feces, wet the surface well and clean using good friction, pay special attention to the toilet and sink,
• Allow the surface to air dry.

Cleaning clothes/other fabric
Wash clothes/fabric separately if they are heavily soiled with feces:

• Rinse off feces
• Clean in a hot water cycle with soap, if possible
• Dry items in the dryer on high heat, if possible
• Dry clean where appropriate

Cleaning dishes
Regular cleaning – use the dishwasher or clean by hand with soap and water.

It is very important that you take all your medication as prescribed by your doctor.  You should not use any drugs from the drugstore that will stop your diarrhea (e.g. Imodium).  If diarrhea persists or comes back, contact your doctor.

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What are the risk factors for CDI?

Certain people are at increased risk for acquiring CDI. These risk factors include:

• A history of antibiotic usage
• Bowel surgery
• Chemotherapy
• Prolonged hospitalization

Additional risk factors that predispose some people to develop more severe disease include:

• Increased age
• Serious underlying illness or debilitation

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How will my doctor know if I have this?

If you have symptoms of CDI, your doctor will ask for a sample of your watery stool. The laboratory will test the stool to see if C. difficile toxins are present.

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How will you treat me if I get this infection?

Treatment depends on how sick you are. People with mild symptoms may not need treatment. For more severe disease, antibiotics are required. Treatment of patients with CDI should be initiated based on the individual patient risk factors and symptoms. Appropriate treatment will be determined by the patient’s attending doctor.

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What happens if I get a CDI while I’m a patient in the hospital?

You will be put on special precautions until you are free from diarrhea for at least two days. (All patients with diarrhea, not only those with C. difficile, should be put on these special precautions). Your activities outside the room may be restricted. All health care staff who enter your room must wear a gown and gloves. Everyone MUST clean their hands when leaving your room.

Always wash your hands with soap and water after using the bathroom and before eating. Cleaning hands is the most important way for everyone to prevent the spread of C. difficile and other germs. As well, a thorough cleaning of your room and equipment will be done to prevent spread of the infection. Ask your visitors to check in with nursing staff if they have not done so already.

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St. Joseph's Public Reporting

What information is being reported on our website?

We have been publicly reporting a number of important patient safety indicators on our website for over three years. St. Joseph's was one of the first hospitals in the city to take the important step of making our information public and transparent to our patients, their families and our community.

On September 26, 2008, the Ministry of Health required all Ontario hospitals to publicly report patient safety indictors on their websites. On the last day of each month, we post:

• rates of new hospital-acquired C. difficile cases; and
• the number of new hospital-acquired C. difficile cases.

The Ministry will also report the same information on its website, at www.ontario.ca/patientsafety.

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How are the rates calculated?

The C. difficile rate is calculated as follows:

Number of new cases x 1000 Total number of patient days (for one month)

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How frequently is St. Joseph's reporting this information?

We post our Clostridium difficilee rate and number of new cases monthly on our website.

We also have a summary of our C. difficile information posted for the last year in a chart as well as a line graph so we can show you how we are performing.

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Page last updated: October 29, 2010