Clostridium Difficile Infection

Clostridium (Clostridioides) difficile Infection

Patient Information

Infection, Prevention and Control Team

• Author ID:      MW
• Leaflet Ref:    IPC 005 
• Version:         10
• Leaflet title:    Clostridium (Clostridioides) difficile infection
• Last review:    August 2025
• Expiry Date:   August 2027

What is Clostridium (Clostridioides) difficile infection?

Clostridium (Clostridioides) difficile (often referred to as C.diff) is a bacterium that can be found in the bowel of a small percentage of healthy people without causing them any harm. In some cases, e.g. people who have been taking antibiotics, the C.diff bacteria can multiply and cause illness.  This happens because the antibiotics affect the bowel, destroying some of the normal protective bacteria and allowing the harmful bacteria to grow. If the C.diff bacteria grow to high levels, they can produce toxins that can cause inflammation to the lining of the bowel and cause symptoms such as:

• Diarrhoea (loose, watery offensive stools)
• Abdominal cramps and tenderness
• Fever
• Feeling sick
• In severe cases, a type of colitis (inflammation of the colon) called pseudo-membranous colitis.

It is therefore very important for the disease to be identified quickly so that appropriate treatment can begin.

Who is at risk of C.diff? 

There are some patients who are more at risk of developing C.diff and include:

• Patients over 65 age group.
• Patients, who have reduced ability to fight infection
• Patients who have received antibiotic treatment, or taken them for a long time, which may also have affected the normal bowel bacteria
• Patients who have been in hospital or care home for a long period of time.

How is C.diff diagnosed?

C. diff is diagnosed by laboratory testing of a specimen of diarrhoea. The results can identify if C. diff is present in the bowel and if there is any toxin being produced. C. diff may be present but not necessarily producing the toxin; however, if a patient is experiencing symptoms of diarrhoea, treatment is usually commenced to prevent progression of the disease.

How is C.diff spread?

C.diff can be picked up on people’s hands and via hand to mouth contact transferring it into the gut. The spores can survive for long periods of time in the surrounding environment, on surfaces, in toilet areas, on clothing and bedsheets.

Healthcare workers, visitors and patients can spread the infection to others by not washing their hands. Alcohol gel is ineffective against C.diff spores, so it is essential that hands are washed with soap and water.

If patients also have a weakened immune system e.g., diabetes, kidney failure and chemotherapy or regularly take proton pump inhibitors (PPI) such as omeprazole. 

How can you prevent spread?

It is important that you wash your hands thoroughly with soap and water, especially after you use the toilet and before you eat. If you need help to do this, please ask a member of staff.

Healthcare staff can prevent the spread of C.diff infection by ensuring that they:

Wear aprons and gloves appropriately when carrying out care and when handling bedpans and commodes.

Wash their hands with soap and water.

Thoroughly clean the environment and clinical care equipment.

Ensure antibiotics are not over-used. Care must be taken to prescribe the correct antibiotics and that these antibiotics are stopped at the earliest opportunity.

How is C.diff treated?

If you are diagnosed with C.diff whilst in hospital, you may be asked to move to either a single room or a designated isolation ward. Your medication will be reviewed and specific antibiotics given to treat the C.diff infection. The medical and nursing team will monitor your symptoms and ensure that you are taking in adequate fluids to avoid you becoming dehydrated. It is important that you report any increase of your symptoms, such as worsening diarrhoea or abdominal pain. 

If you are at home, your GP will be contacted with your results by the Microbiologist. Your GP will then arrange appropriate antibiotic treatment for you if this is required. 

Will this affect any of my treatment?

No. Your treatment and investigations will continue, with the staff undertaking the correct infection control precautions. Occasionally, non-urgent investigations may be delayed if you have uncontrolled or severe diarrhoea.

Can I have visitors?

Yes, you may still have visitors. However, if any are elderly, prone to infection, or have an active infection that is being treated with antibiotics, they may be at an increased risk of C.diff. Advice should be sought from your clinical care team if they are concerned. Healthy people have very little risk; however, all your visitors will need to wash their hands with soap and water on entering and leaving the ward or your home. Visitors are not required to wear gloves and aprons, unless they are helping you with personal care or treatment whilst you are in hospital.

Can my laundry be sent home?

Yes. The ward has information leaflets and bags in which to send your laundry home. Your relatives/ carers can speak to staff regarding this.

Can I still go home?

C.diff will not affect your discharge home, providing you are medically stable. However, if you are still having frequent diarrhoea, or you are being discharged to a Care home, you may need to stay in hospital until it settles. If you suffer from increasing diarrhoea again after you have returned home, you should contact your GP. The hospital staff will let your GP know that you have had C.diff infection whilst you were in hospital. 

How can I stop the spread of C.diff once I am home?

• Stay at home until at least 48 hours after your symptoms have cleared.
• Wash your hands with soap and water before eating or preparing food and after using the toilet as a minimum. Use liquid soap rather than a bar of soap, and don’t use flannels or nail brushes.
• Clean potentially contaminated surfaces such as the toilet, flush handle, light switches and door handles after each use.
• Do not share towels and wash cloths.
• Wash contaminated clothes and sheets separately from other washing, using the highest possible temperature for the fabric.

Looking after yourself at home

It is important that you complete the entire course of any antibiotics you are prescribed, even if you are feeling better. Do not take anti-diarrheal medication, as this can prevent the infection from being cleared from your body. You may take paracetamol for stomach pain or a fever. Drink lots of fluids to avoid dehydration, and eat plain foods, such as soup, rice, pasta, and bread if you feel hungry.

Contact your GP or out of hours GP service if your symptoms do not improve or get worse (e.g. fever, acute pain or abdominal swelling); make them aware of your C. diff diagnosis.

Can C.diff symptoms re-occur? 

There is a possibility that C.diff infection and associated symptoms may recur. If your symptoms do return, you should contact your GP for advice and appropriate treatment. To prevent re-occurrence when using healthcare services in the future, ensure that you inform the Care team that you have previously been diagnosed with C.diff. 

Who can I contact for further information?

If you have any questions or would like further information about C.diff please do not hesitate to contact a member of staff whilst in hospital, or your GP once discharged home.