C. Diff – hospitals and nursing homes
Clostridium difficile is a contagious disease. However, it usually doesn’t spread directly from one person to another like influenza, strep throat or common colds. Patients pick up C. diff from the environment, typically a hospital or nursing home. The following post will explore C. diff in hospitals and nursing homes, as well as other types of C. diff transmission.
Here’s how C. diff spreads in hospitals. Let’s imagine a C. diff patient, Mrs. Smith, in Room 503 in our hospital. She has acute C. diff infection and is passing liquid stools (diarrhea) 10 times per day. Billions of C. diff organisms are in her stools. Tiny amounts of the C. diff organisms get on the sheets, linen, toilet seat, telephone, and floor in her room.
Doctors come in to Room 503 to examine Mrs. Smith. They may pick up C. diff spores on their hands, clothing or stethoscopes. Depending on how well they wash their hands and clean their stethoscopes, C. diff can hitch a ride to the next patient they examine and infect that patient … especially if that patient is taking an antibiotic.
Once C. diff leaves the colon of the infected patient in a liquid stool, it usually converts to a spore that is like a seed that lies dormant in the hospital until it gets picked up by a suitable human host. Once swallowed, C. diff germinates (hatches) in the bowel and starts a new cycle of infection.
Since the spores of C. diff are able to survive for months or even years in the hospital environment, it’s possible that spores from one patient can infect another patient admitted to the same hospital room even months later. It is almost impossible to know with certainty how or where a given patient picks up C. diff, because the spores are so common in the hospital environment. Spores of C. diff can be found in soil, in the home, and even in the supermarket. Patients pick them up on their hands and transfer them to their mouth when they eat.
Airborne and person-to-person C. diff transmission
Note, however, that airborne transmission doesn’t happen for a stomach infection, as airborne particles end up in the lungs (like the common cold, which can be transmitted by a sneeze). C. diff germinates in the bowel.
Person-to-person transmission is also rare. It’s extremely unlikely for a husband with a C. diff hospitals infection to pass it to his wife, or for a parent to pass it to his child, unless the wife or the child is taking an antibiotic.
However, spread from one patient to another in the same hospital room can occur. Because of this, patients diagnosed with C. diff are usually moved to a private room.
When patients with C. diff are discharged from the hospital, their room and furniture are cleaned thoroughly with bleach to kill C. diff to prevent the next patient from getting infected. Doctors are required to clean their hands with hand sanitizer or soap and water before and after examining a patient. When this rule is strictly enforced, it reduces the rate of C. diff infection in hospitals and nursing homes.
This article was excerpted from C. Diff In 30 Minutes: A guide to Clostridium difficile for patients and families by Dr. J. Thomas Lamont, M.D.