Introduction:
Clostridium difficile is a bacterium that affects the bowel in people on prolonged antibiotics course, resulting in diarrhea. Clostridium difficile is also called C. difficile or C. diff, a bacterium capable of causing symptoms like diarrhea or some severe infections like inflammation of the colon. The most commonly affected people are with a compromised immune system, who are older hospitalized people, or the ones who are taking medications for a long time.
What Are the Symptoms of Clostridium Difficile Infection?
The signs and symptoms may vary from mild to severe, depending on the stage or severity of the condition. Mild symptoms involve the following:
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Diarrhea that is too watery and frequency accounts for three to four times in a day and the days being two to three days.
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Cramps in the abdomen that is mild in nature and associated with tenderness.
Severe symptoms in people can lead to severe dehydration, and ultimately, they might require hospitalization. Clostridium difficile can affect the colon by causing its inflammation and forming raw tissue patches that can cause bleeding or pus exudation. The signs and symptoms of a severe type of infection include the following:
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Diarrhea that is too watery, lasting ten to 15 times a day.
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Pain and cramps in the abdomen that is very severe.
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Increased or fast heart rate.
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High temperature or fever.
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Presence of blood or pus in the stool of the patient.
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Nausea.
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Loose motions or diarrhea.
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Appetite loss.
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Loss of weight.
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Swelling of the abdomen.
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Kidney issues like kidney failure.
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Presence of increased white blood cells.
As severe Clostridium difficile can cause severe inflammation of the colon, it can also cause colon enlargement, which is also known as toxic megacolon, and in some cases, sepsis may be caused. People having severe symptoms are usually hospitalized.
How Does Clostridium Difficile Enter the Human Body?
C.difficile is a common microorganism that is found everywhere in the environment, like water, soil, air, processed meats, etc. It is interesting to know that they are also found commonly in the intestines of human beings, and it stays as a common commensal there without causing any infection. The spores of these organisms can pass through feces and spread to various surfaces, foods, etc. It is known that the spores of these microorganisms can survive up to weeks or months in a room or place. Finally, if the infected surface is touched by a person, they might swallow the pores while eating without washing their hands. When these spores reach the intestine, it starts to produce toxins that can affect the intestinal lining, and also, the toxins can lead to cell destruction, production of patches, plaques of cells of inflammation, and finally, lead to loose stools.
What Are the Risk Factors for Developing Clostridium Difficile Infection?
The following can increase the risk of getting Clostridium difficile:
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Intake of certain antibiotics like fluoroquinolones, cephalosporins, Penicillin, Clindamycin, proton pump inhibitors, etc.
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Presence of any serious health issues or who has undergone any medical or surgical procedure.
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Women have more chances to get than males.
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Elderly people are more prone to get infected.
What Are the Potential Complications of Clostridium Difficile Infection?
Following are the potential complications of the Clostridium difficile infection:
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Dehydration - Diarrhea leads to loss of fluids and electrolytes, causing dehydration. This interrupts normal body functions and can cause a severe drop in blood pressure levels.
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Kidney Problems - Dehydration can deteriorate kidney function leading to kidney failure.
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Toxic Megacolon - In rare cases, due to the inability to expel gas and stool, the colon becomes greatly enlarged and can rupture if left untreated.
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Perforation of the bowel - It is the hole in the lining of the intestine that results from extensive damage.
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Death - Severe infection can progress quickly to fatal disease if not treated properly.
How to Prevent Getting Infected with Clostridium Difficile?
It can be prevented by following the below-mentioned levels:
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Usage of antibiotics unnecessarily should be avoided, as it can decrease the natural potential of the body to fight against even the common commensals of the body.
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Wash your hands properly.
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Precautions should be taken to isolate the people who are affected with C.difficile infection and those who are visiting them.
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Complete cleaning of all the surfaces being touched or coming in contact with the affected person.
How to Diagnose an Infection by Clostridium Difficile?
When you visit your physician, he or she will ask you detailed questions about your personal history, signs, and symptoms and the complaint of loose stools makes the physician suspect C.difficile infection. Following this, the doctor will ask for the following details and tests to come to a conclusion or final diagnosis in order to provide the apt treatment accordingly.
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Stool Tests - It is done to identify the toxins produced by the bacteria and strains of the bacteria.
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Polymerase Chain Reaction - It is a laboratory technique to amplify small segments of DNA (deoxyribonucleic acid). It is done to detect the C.difficile toxin B gene.
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Glutamate Dehydrogenase (GDH) Test - Glutamate dehydrogenase is an enzyme that is produced by all strains of the Clostridium difficile bacteria. A positive result for this enzyme indicates the presence of this bacteria in the body.
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EIA (Enzyme Immunoassay) - It is an inexpensive and fast method to detect Clostridium difficile.
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Cell Cytotoxicity Assay - It is a test done to measure the ability of the cytotoxic substances to cause cell death or damage.
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Colon Examination - It is done to confirm the diagnosis and check for other causes of the symptoms. It is done by sigmoidoscopy or colonoscopy, which involves inserting a thin, flexible tube with a camera into the large intestine.
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Imaging Tests - Imaging tests like abdominal X-ray and computed tomography (CT) scan (detailed image creation of the affected region using sound waves) are helpful in providing images of the large intestine. It is useful in detecting the presence of complications.
What Are the Treatment Options for Clostridium Difficile Infection?
The first line of management involves stopping the medication that actually initiated the condition. The next line of management is advised based on the stage and severity of the condition and may include any of the following:
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Medication - Antibiotics are the mainstay in the treatment of infection by Clostridium difficile. Commonly used antibiotics are Vancomycin, Metronidazole, and Fidaxomicin.
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Surgery - Surgery involves the removal of the diseased portion of the large intestine. It is recommended in case of severe conditions like organ failure, severe pain, inflammation of the abdominal wall lining, and toxic megacolon.
Is There a Possibility of Recurrence of Clostridium Difficile Infection?
Yes, it might recur in cases of the elderly and has a 20 % chance of recurrence. Others who may experience the recurrence are those who are taking antibiotics for other conditions while on antibiotic therapy for C.difficile infection. People with immunocompromised states or other severe medical conditions may face recurrence. Treatment for recurred conditions includes antibiotics or a transplant (fecal microbiota transplant) or may be both. C.difficile is a common condition, but if not treated in the proper time can lead to severe complications, even death. It is important to have detailed information about the same. With the help of online medical platforms, it has become easy to consult a physician at the ease of home.
Conclusion:
Clostridium difficile is a germ or bacterium that causes inflammation of the large intestine and diarrhea. It can affect anyone, though older patients are at a higher risk. It is contagious and spreads by touching the contaminated surface. Approximately one in six people who have had Clostridium difficile get infected again in two to eight weeks.
