Clostridium difficile infection and taking antibiotics

You have received antibiotic treatment for a respiratory infection, and a week later, you have watery stools and abdominal tenderness. You are breathing better but now you are nauseated.

You could be experiencing a consequential gastro-intestinal infection caused by clostridium difficile bacteria (C. difficile).

This microorganism is ever-present in our environment, but as long as our immune system is working right, we can effectively fight it off. However, when you take antibiotics, not only does it kill the intended harmful germ, it also destroys the good germs that protect you against other infections over a period of time. Those most at risk are the older adults who take antibiotics and who also get medical care. C. difficile infection is highly communicable.

According to statistical reports, more than a half million people get sick from C. difficile every year. In recent years, the infections have become more frequent, severe and difficult to treat. New aggressive and resistant strains have emerged. The infection can be mild to severe.

These are the common symptoms:

• Watery diarrhea three or more times a day for two or more days (more frequent if severe).

• Mild abdominal cramping and tenderness.

• Fever.

• Loss of appetite.

• Nausea.

• Blood or pus in the stool.

• Dehydration

• Weight loss.

• Swollen abdomen. See your health care provider if you have three or more watery stools a day with symptoms lasting more than two days or if you have a new fever, severe abdominal pain or cramping, or blood in your stool. Severe complication may include kidney failure, a much distended colon and extensive damage to the lining of your large intestines or colon causing a perforation or a hole. A hole in your colon can spill bacteria into your abdominal cavity leading to a life-threatening infection.

C. difficile causes inflammation of the colon. This bacterium is found in the soil, air, water, human and animal feces, and food products such as processed meats. Its spores can live outside of a human host for a long period of time.

Any surface, device or material is a suitable reservoir. It can be transferred mainly via contaminated hands that may have touched the contaminated feces directly or any contaminated surfaces, devices or materials. Healthcare workers can spread the bacteria to patients or contaminate inanimate objects through hand contact. We can help control the spread of infection.

The Centers for Disease Control and Prevention advises us to:

• Take antibiotics only as prescribed by your doctor. Antibiotics can be lifesaving medicines.

• Tell your doctor if you have been on antibiotics and get diarrhea within a few months.

• Wash your hands after using the bathroom.

• Try to use a separate bathroom if you have diarrhea, or be sure the bathroom is cleaned well if someone with diarrhea has used it.

Thorough cleaning of contaminated surfaces, devices and materials should be done using disinfectant products that contain chlorine bleach. C. difficile spores can survive routine cleaning products that do not contain bleach.

If you are admitted in a hospital or long-term healthcare facility, strict isolation protocols are put in place to prevent the spread of infection. You will be admitted to a single room in contact isolation employing protective devices such as gloves, isolation gown, and googles. You will also be treated with fluids and specific antibiotics prescribed by your doctor. Surgical intervention is needed for ruptured or perforated colon.

If you are at home with diarrhea, here are some supportive treatments you can employ as advised by the Mayo Clinic staff:

• Consume plenty of fluids. Choose fluids containing water, salt and sugar, such as diluted fruit juice, soft drinks and broths.

• Good nutrition. If you have watery diarrhea, eat starchy foods, such as potatoes, noodles, rice, wheat and oatmeal. Other good choices are saltine crackers, bananas, soup and boiled vegetables. If you are not hungry, you may need a liquid diet first. After your diarrhea subsides, you may have temporary difficulty digesting milk and milkbased food products.