C. diff risk factors: antibiotics, age and hospital stays

What C. diff is

Clostridioides difficile, also known as Clostridium difficile and often called C. difficile or C. diff, is a bacterium (germ) that causes diarrhea and inflammation of the colon (CDC). C. diff is estimated to cause almost half a million infections in the United States each year (CDC).

Who is more likely to get C. diff

C. diff infection can affect anyone, but most cases occur while or soon after taking antibiotics (CDC). You are more likely to get a C. diff infection if you (MedlinePlus):

• are taking antibiotics
• are 65 or older
• recently stayed in a hospital or nursing home
• have a weakened immune system
• have had a previous infection with C. diff or were exposed to it

The CDC adds detail to these (CDC):

• Antibiotic use: people are up to 10 times more likely to get C. diff infection while taking an antibiotic and during the month after finishing it, and longer courses of antibiotics may double the risk. MedlinePlus says you are more likely to get C. diff if you take antibiotics for more than a week (MedlinePlus).
• Healthcare settings: C. diff infection is more common among patients in hospitals and nursing homes, because many people who have C. diff stay or get treated in those facilities.
• Weakened immune system: for example, people with cancer or organ transplants taking drugs that suppress the immune system.

You can still get C. diff infection even if you have none of these risk factors (CDC).

Why antibiotics raise the risk

Antibiotics kill harmful bacteria, but they can also kill helpful bacteria in your gut. This can weaken your body's natural defenses and allow C. diff germs to grow (CDC). The effects of antibiotics on the gut can last for several months, and if you come in contact with C. diff germs during this time, you can get sick (CDC) (MedlinePlus).

C. diff spreads when people touch food, surfaces, or objects that are contaminated with feces (poop) from a person who has C. diff (MedlinePlus). Outside the body, C. diff forms spores that can live for months or years on surfaces and in the soil, but most healthy people don't get infected even if spores reach their intestines (CDC).

Symptoms

Symptoms of C. diff infection include (CDC) (MedlinePlus):

• diarrhea (loose, watery stools) or frequent bowel movements for several days
• fever
• stomach tenderness or pain
• loss of appetite
• nausea

Not all diarrhea while on or after antibiotics is caused by C. diff (CDC). Severe diarrhea causes you to lose a lot of fluids, which can put you at risk for dehydration (MedlinePlus).

Complications

Common complications are dehydration and inflammation of the colon (colitis). Rare complications include a severe life-threatening intestinal condition called toxic megacolon, sepsis (the body's extreme response to an infection), and death (CDC).

About 1 in 6 people who have had a C. diff infection will get it again within the following 2 to 8 weeks. Contact your provider if your symptoms come back (MedlinePlus).

Lowering your chances

Any time antibiotics are used, they can increase your risk of C. diff infection. Talk with a healthcare professional about your risk when starting an antibiotic, and what to do if you develop symptoms (CDC). To reduce the spread of C. diff germs (CDC) (MedlinePlus):

• wash your hands with soap and water every time you use the bathroom and always before you eat
• clean and disinfect surfaces and laundry
• if you have diarrhea, clean the bathroom you used before anyone else uses it, using bleach mixed with water or another disinfectant on the toilet seat, handle, and lid

Common questions

Which antibiotics raise the risk of C. diff?

The CDC says any time antibiotics are used, they can increase your risk of developing C. diff infection (CDC).

Can you get C. diff without taking antibiotics?

Yes. C. diff can affect anyone, and you can still get it even if you have none of the risk factors (CDC).

Is age a risk factor for C. diff?

Yes. Being 65 or older is on both the CDC and MedlinePlus lists (CDC) (MedlinePlus).