Clostridium difficile

Clostridium difficile

Clostridium difficile (C. difficile) is a harmful variant of the common intestinal bacterium Clostridium. C. difficile is an anaerobic, spore-forming bacterium that can cause diarrhoea when the normal gut flora is disrupted. The bacterium produces two toxins: enterotoxin and cytotoxin. Diarrhoea is mainly caused by enterotoxin. C. difficile can cause serious damage and can even be fatal. In addition to harmful C. difficile, the Clostridium class also includes beneficial bacterial species that are present in large numbers in the intestine. Normal stool contains 1.0·10^{^9} to 1.0·10^{^10} bacteria per gram of stool. Clostridium species account for 30% of the intestinal microbiota.

Number of Clostridium difficile infections per year

Every year, more than half a million people become infected with C. difficile. In recent years, C. difficile infections have become more frequent, more severe and more difficult to treat. Research in hospitals shows that 18 people per 10,000 admissions test positive for Clostridium difficile. The infection also occurs outside healthcare institutions, particularly among older patients with diarrhoea.

Diagnosis of Clostridium difficile

C. difficile toxins can be measured quickly and easily in stool. Detection of C. difficile toxins in faeces is performed using an immunoassay.

Risk factors for infection

The likelihood of infection is increased by:

• The use of acid-suppressing medicines.
• Reduced resistance. People with a healthy immune system experience few problems from an infection, but older people and people in poor health may be unable to break down the toxins.

Prevention

A person can become infected with this bacterium in hospital or through contact with, for example, a family member. C. difficile spreads via contaminated objects and surfaces. It is therefore important to pay close attention to keeping the environment clean. Spores are resistant to drying, heat and chemicals. They can therefore remain present in bathrooms, bedside tables, thermometers and similar objects.

Treatment

Treatment of an acute C. difficile infection consists of prescribing oral antibiotics (metronidazole, vancomycin). These antibiotics specifically target this bacterium. In addition to taking antibiotics, it is important that the gut flora is given the opportunity to recover. The gut flora can recover, among other things, by stopping the use of unnecessary antibiotics. If another antibiotic is being used, it should only be stopped in consultation with a doctor. A probiotic may have a beneficial effect on the gut flora.

About Darmklachten.nl