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About Clostridium difficile Infection.

The following excerpts are drawn from the American Gastroenterological Association's FMT website, a helpful resource for patients, physicians, and the public to learn about FMT and its uses, especially regarding treatment of C. difficile infection. 

What is C. difficile?

Clostridium difficileC. difficile for short – is a rod-shaped bacterium usually found in the soil, air, water, and human and animal feces. This aggressive intestinal bug infects about 500,000 Americans and causes up to 30,000 deaths each year, making it one of the most common hospital-acquired infections in the United States.

The bacteria produce toxins that destroy cells and cause inflammation, resulting in symptoms such as watery diarrhea three or more times a day, abdominal pain, and nausea. In more severe cases, the degree of inflammation in the colon may be more extensive and symptoms may include: watery diarrhea as often as 15 times per day, severe abdominal pain and cramping, fever and weight loss. 

How does C. difficile spread?

Up to 10% of the population is thought to carry C. difficile. Though these individuals don't show symptoms, they still shed the bacterium through their feces and expose others if they don’t practice proper hygiene. For example, when people who carry C. difficile do not wash their hands after going to the bathroom, they can contaminate food and leave the bacteria on surfaces, exposing others who come into contact with them.

Where is it usually found?

C. difficile is commonly found in hospitals and long-term care facilities, such as nursing homes. Studies suggest that up to 20% of hospital patients and 50% of people in long-term care facilities carry C. difficile, even though many may not present symptoms. Unless a health facility follows special procedures for disinfection, C. difficile’s bacterial spores can remain on beds, toilets and medical equipment for months, and spread easily between health care providers and patients. 

Who is at risk for developing C. difficile infection?

Healthy individuals are less likely to develop C. difficile infection thanks to the diversity of microorganisms in their gut. Though we often associate bacteria with illness, many bacteria are vital to maintaining health, and they help prevent C. difficile infection by occupying the sites on the intestinal wall where C. difficile could attach and multiply.

However, patients and immunocompromised individuals are at an increased risk of developing infection. They often take antibiotics, which can wipe out these helpful organisms and leave room for C. difficile to lodge itself in the intestinal wall and multiply. In addition to antibiotic use, other risk factors include:

  • Being at least 65 years old
  • Having abdominal surgery
  • Having an existing health condition related to your intestines such as Irritable Bowel Disease; and
  • Previous infection with C. difficile

How can C. difficile infection be treated?

C. difficile infection is usually treated with antibiotics, but about 20% of patients continue to suffer from repeated infections. For this subgroup of patients, a promising new treatment called Fecal Microbiota Transplantation (FMT) brings hope. Physicians have discovered that transplanting screened and processed fecal material from a healthy donor into the colon of a sick patient can cure C. difficile infection in 90% of cases. For those who have spent months or even years restricted by their proximity to a bathroom, FMT can truly restore their quality of life. 

 

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