From the Guidelines
Yes, a person can develop Clostridioides difficile (C. diff) infection without being a carrier beforehand. C. difficile (C. diff) is a bacterium that causes inflammation of the colon, leading to symptoms like diarrhea, fever, and abdominal pain. Most people who develop C. diff infection acquire the bacteria during healthcare exposure or from contaminated environments [ 1 ]. The infection typically occurs after taking antibiotics, which disrupt the normal gut bacteria that usually keep C. diff in check. According to a study published in 2020 [ 1 ], the main risk factors for CDI include antibiotic exposure, age more than 65 years, comorbidity or underlying conditions, inflammatory bowel diseases, immunodeficiency, malnutrition, and low serum albumin level.
Key Points to Consider
- Asymptomatic carriage of C. difficile affects 10 to 52% of defined populations [ 1 ].
- Asymptomatic colonization does not increase the risk of symptomatic CDI, and may protect against later development of symptomatic disease [ 1 ].
- A study by Shim et al. found that 3.6% of non-colonized patients and only 1% of asymptomatic carriers developed symptomatic CDI [ 1 ].
- The distinction between non-carriers and carriers is important because non-carriers who develop infection have acquired the bacteria from an external source, highlighting the importance of infection control measures in healthcare settings [ 1 ].
Treatment and Prevention
- Treatment for C. diff infection generally includes stopping the offending antibiotic if possible and starting specific antibiotics like oral vancomycin, fidaxomicin, or metronidazole for mild cases [ 1 ].
- Hand hygiene with soap and water and the use of contact precautions along with a good cleaning and disinfection of the environment and patient equipment should be used by all healthcare workers contacting any patient with known or suspected CDI [ 1 ].
- Patients with CDI should be maintained in contact (enteric) precautions until the resolution of diarrhea [ 1 ].
From the Research
Development of C. diff Infection
- A person can develop Clostridioides difficile (C. diff) infection without being a carrier, as the infection is often caused by the use of antibiotics that alter the gut microbiome 2.
- The infection can be acquired through various means, including hospitalization, and can lead to severe complications such as septic shock and fulminant colitis 3, 4.
Asymptomatic Carriers
- Asymptomatic carriers of C. diff can pose a major threat to the healthcare system, as they can transmit the infection to others 2, 5.
- The presence of asymptomatic carriers highlights the importance of proper infection control measures and treatment strategies to prevent the spread of C. diff infection.
Treatment and Prevention
- Various treatment options are available for C. diff infection, including antibiotics, fecal microbiota transplantation, and microbiome restoration therapies 4, 5, 6.
- Newer treatment approaches, such as alternative therapeutic strategies and standardized microbiome-based therapies, are being developed to improve treatment outcomes and prevent recurrence 5, 6.