What is C difficile? (Clostridium difficile) Patient information leaflet

Transcription

1 What is C difficile? (Clostridium difficile) Patient information leaflet

2 What is C difficile? C difficile is short for Clostridium difficile, a rod-shaped bug that lives in the bowel of less than 5% of the population. C difficile is kept in check by the friendly bacteria of the bowel. C difficile most commonly affects elderly people who have underlying diseases. C difficile produces small structures called spores that are very resistant to heat, cold, dryness and moisture. When a person is infected with C difficile, huge amounts of spores are excreted in the faeces. The spores then contaminate things like clothing, bed linen, carpets, furnishings and toilet seats and can infect the people who touch them. What does C difficile cause? C difficile causes diarrhoea ranging from a mild attack to very bad diarrhoea with stomach cramps. Severe illness can lead to ulceration and bleeding of the bowel, known as colitis. How do I get infected with C difficile? C difficile infection can be caught in 2 ways: 1. Antibiotic therapy C difficile usually starts with antibiotic therapy, particularly those antibiotics used to treat a wide variety of infections, known as broad spectrum antibiotics. Antibiotics can alter the balance of the normal friendly bacteria in the gut, allowing C difficile to take over. The C difficile then produces 2 toxins (poisonous substances) that affect the bowel wall, leading to diarrhoea. Because C difficile develops in this way, repeated courses of antibiotics or treatment with broad spectrum antibiotics can lead to C difficile infection. 2

3 l Only take antibiotics for a bacterial infection and not for colds or the flu. l Complete the course of antibiotics as prescribed even if you are feeling better or the infection may return later. 2. Cross infection Cross infection can happen when there is contact with an infected person or when contaminated articles are handled. A person infected with C difficile sheds large amounts of spores in their faeces, which then contaminate things like bed linen, toilet seats, clothing, surfaces and door handles. C difficile infection can then occur during contact with the patient themselves e.g. when giving personal care. Infection can be spread when contaminated items are handled e.g. making the bed and then eating food without washing your hands. What can I do to protect myself from C difficile infection? 4 Wash your hands frequently with soap and water alcohol hand gel is ineffective against C difficile! 4 It is OK to challenge healthcare staff and carers to wash their hands before and after they care for you in fact we appreciate a gentle reminder! 4 Make sure you wash your hands before preparing or eating food, having a drink or taking medication. 4 Make sure you wash your hands after using the toilet and after doing jobs like cleaning, especially in the bathroom. 4 Maintain good standard of cleanliness in your home and especially the bathroom toilet, toilet seat, taps and door handles. 4 Use normal household products for cleaning and vacuum carpets so that your home is dust free. 4 Avoid sharing personal care items such as towels and facecloths. 3

4 Where does C difficile infection occur? C difficile is mainly associated with hospital care but in the community it can occur in care homes, community hospitals and also the patient s own home. How will I know if I have C difficile? You won t know for sure until a test has been done on your faeces. You should however suspect C difficile if you experience diarrhoea 3 or more times in one day and l Have recently had or been started on antibiotics, or l Have been in contact with a person infected with C difficile. What do I do if I suspect I have C difficile? l You must contact your GP practice and explain the situation please let the receptionist know if you have very bad diarrhoea and are unable to attend the surgery. l Your GP will then advise on what to do it is routine to send a sample of faeces to the hospital to be tested. How is it diagnosed? A sample of diarrhoea is tested at the hospital laboratory for the presence of the 2 toxins. 4

5 How is C difficile treated? l Luckily, most people have only a mild infection, which usually settles when the GP stops the antibiotics. Most people respond well with plenty of fluids and rest. l Often antibiotics to treat C difficile itself are given and this course must be completed as advised by your GP. l IMPORTANT! After an initial infection always let the doctors and nurses know that you have had C difficile this will help in your management should you need antibiotics in future. What about probiotics are they of any benefit to me? Probiotics are live bacteria with some benefit as part of the diet. However, there is little evidence that they are of any benefit in the prevention of C difficile. A healthy and well-balanced diet is recommended to protect against all infections. Can I go to work if I have C difficile? As long as you have diarrhoea you are still infectious and should not go to work. In fact you should not go back to work until you have been free of diarrhoea for 48 hours. You should inform your employer that you have had C difficile if you l Are a food handler. l Work with vulnerable groups; infants, children or the elderly. l Work with ill people e.g. nursing, carer. 5

6 Questions and answers I am pregnant is C difficile a problem in pregnancy? C difficile is very unusual in the under 65-age group and so is very rare in pregnancy. However, should C difficile be acquired during pregnancy, it is not known to cause any abnormalities in the baby. You should see your GP who will advise on whether any treatment is needed. My father had C difficile in hospital and is now at home does he need any special treatment? The good news is no he doesn t. A patient is not discharged from hospital until they have been free of diarrhoea for 48 hours. As long as your father is free of diarrhoea he is no longer infectious. You may think you have to keep up the strict measures that were put in place in the hospital but you don t. Please rest assured that these measures are intended to keep other ill patients safe from C difficile. The risk at home is very small. It is important for your father to keep up a good standard of hand washing and personal hygiene. The C difficile may be triggered by antibiotics in future so it is good to remind doctors and nurses that your father has previously had C difficile infection. A good standard of housekeeping should be kept up, especially in the bathroom toilet seats, taps and handles should be cleaned regularly. If a member of my family has C difficile, what precautions do I need to take to prevent us becoming infected? Firstly, remember that if the person does not have diarrhoea then the risk of infection to other family members is very low. The diarrhoea may recur when antibiotics are prescribed and it is useful to be aware of this. It is good to get into the habit of washing your hands after using the toilet, before eating, drinking or taking medication. 6

7 Advice for the infected person l Good handwashing with soap and water is the most important action you can take alcohol hand gel is ineffective against C difficile. It is important to wash your hands after going to the toilet and before eating food or taking medication. l While you have diarrhoea you should avoid handling or preparing food for other people. l Don t share things like towels, facecloths with other people. l After using the toilet, wipe the flush handle and clean round the toilet seat with bleach and hot water then wash your hands. What should I do if there is an accident? Prepare the following things first l A plastic bag l A pair of disposable gloves l Some paper kitchen towel l A cloth either disposable or wash in a washing machine on at least a 60 C wash* l A bowl or bucket with 1 part bleach to 10 parts hot water. * Cloths contaminated with C difficile will spread C difficile round the house it is vital to throw them away after use or launder at least on a 60 C setting. 1. Put the gloves on. 2. Take some paper towel and remove as much of the faeces as possible and dispose of in the plastic bag (or toilet if nearby) 3. Remove all visible soil using paper towel and bleach solution. Dispose of paper towel. 4. Clean area again using the cloth dispose of or launder. 5. Remove gloves and dispose of in plastic bag. 6. Tie the top and dispose of in household waste. 7. Wash hands in soap and water. 7

8 For further advice please contact: Liverpool Primary Care Trust Infection Control Team on