According to research published in the New England Journal of Medicine, it was estimated that the bacterium Clostridium Difficile contributed to approximately half a million infections with about 29,000 deaths in 2011. The study also suggested that about 66% of the infections were health-care related among the age of 65 and over.

Illness from Clostridium Difficile (or commonly called C. diff) usually occurs after multiple uses of antibiotic medications. The most common antibiotics that can cause C. diff include Fluoroquinolones, Cephalosporin, Clindamycin and Penicillin. Frequent use of antibiotics can destroy the normal or healthy bacteria in the intestinal tract and allow the rapid growth of C. diff when there is inadequate supply of the good bacteria. Symptoms of the disease range from moderate to severe including but not limited to: watery diarrhea ranging from two to fifteen times per day, abdominal cramping and pains, fever, nausea, loss of appetite, weight loss, dehydration, kidney failure and death, if not treated immediately.

The bacterium Clostridium Difficile is found almost everywhere. It is found in water, soil, human and animal feces, and in processed meats. Without proper handwashing, the bacterium is transferred from feces to food, surfaces and objects. In health care setting, the bacteria can be transferred from hand to hand, food trays, dining tables, bed rails, bedside tables, stethoscopes, thermometers, sinks, and toilets. The C. diff bacteria also produce spores that can stay in an area for extended period of time.

Testing methods for C. diff include stool tests, colon examination, and imaging tests (abdominal X-ray, CT scan) depending on the severity or complications of the disease. Treatment unfortunately includes the use of antibiotics (Flagyl, Vancomycin, and Dificid) to prevent the growth of the bacteria C. diff. In severe cases there can be organ failure, severe pains and increased inflammation of the abdominal wall, and surgery may be considered.

Strict preventive measures for the spread of C. diff in health care facilities include: proper handwashing with soap and water and use of disposable gloves and aprons during patient care; isolate the infected resident in a private room or have them share a room with another resident with C. diff; thoroughly clean surfaces and sanitize them with chlorine solution and avoidance of unnecessary antibiotic use are other ways health care facilities implement to prevent the spread and recurrence of the disease. The use of hand sanitizer is known to be ineffective in destroying the bacteria C. diff so is not recommended.

“Today’s Dietitian” states several dietary management tips were suggested to help in the healing process and prevention of C. diff. Foods containing probiotics, for example, yogurt and fermented foods (soy products) have been known to help restore healthy bacteria in the intestinal tract and prevent the regrowth of C. diff. It is also suggested that certain brands (Stonyfield Farm) of yogurt contain live cultures and are more beneficial. According to research studies, Culturelle, a probiotic supplement available over-the-counter, has been found to help repopulate the intestinal tract with healthy bacteria as well. The consumption of foods high in soluble fiber is believed to help in a more rapid recovery from the C. diff infection. Examples of foods containing soluble fiber include: oats, oat bran, oatmeal, beans, peas, rice, bran, barley, citrus fruits, strawberries and apple pulp. Another over-the-counter supplement called Banatrol Plus which contains pectin and soluble fiber is believed to control diarrhea, and, therefore can be beneficial in the treatment process of C. diff as well.

A recent study published in the Therapeutic Advances in Gastroenterology, concluded a probiotic supplement called Florastor which contains the live yeast Saccharomyces Boulardii has been found to be most effective in prevention of antibiotic-associated diarrhea and recurrence of C. diff. The prevalence of C. diff can be devastating. With available testing methods, infection controls, treatment and prevention options and products, one can hope that the incidence of this life threatening condition can be dramatically reduced or eliminated.

Website references:

www.mayoclinic,org “C-diff infections”

www.nejm.org “Burden of Clostridium Difficile Infection in the United States”

www.tag.sagepub.com “Efficacy and Safety of Probiotic Saccharomyces Boulardii.”

www.todaysdietitian.com “Combating Clostridium Difficile”