Clostridium difficile. RDaSH. Handwashing is the simplest and easiest way of preventing the spread of infection

Transcription

1 Clostridium difficile RDaSH Handwashing is the simplest and easiest way of preventing the spread of infection

2 What is Clostridium difficile (C. diff)? Clostridium difficile is a bacterium (germ). It lives harmlessly in the intestines (gut) of many people. About three in one hundred healthy adults and as many as seven in ten healthy babies have a number of C. diff bacteria living in their gut. The number of C. diff bacteria living in the gut of healthy people is kept in check by all the other good bacteria that also live in the gut. What does C. diff cause? C. diff can cause an infection in the gut this is referred to as Clostridium difficile infection (CDI). The infection usually occurs because the good bacteria numbers lessen, allowing the C. diff to multiply and start producing toxins (poisons). The toxins can cause inflammation and damage to the inside lining of the lower gut. There are many different strains of C. diff and some can cause a more serious illness than others. The severity of the infection and illness can vary greatly. Strain 027 produces more toxins than most strains and is more likely to cause severe illness. Symptoms and treatment of CDI Not all people with a CDI experience all of the symptoms. Symptoms include: Mild to severe explosive diarrhoea - which may be foulsmelling Stomach cramps or tenderness Fever Loss of appetite Nausea. 2 Clostridium difficile

3 It is important in all cases to drink enough fluids so that you do not become dehydrated because of the diarrhoea. If specific treatment is needed this will be a course of antibiotics that are effective against C. diff bacteria. Mild to moderate illness Most people only become mildly or moderately ill, with symptoms lasting from a few days to a few weeks. In mild cases the symptoms often clear without any specific treatment. If you have been taking a course of antibiotics and develop a CDI you may be asked to stop taking these. Severe illness Pseudomembranous colitis occurs in rare cases and is very serious. It is a severe acute inflammation of the lining of the colon (bowel) with the formation of plaques (patches) on the lining of the colon. This can cause blood in the diarrhoea, abdominal pain and fever. In some cases it becomes severe and lifethreatening. Testing for C. diff You may be asked to supply a faeces (poo) sample for testing in the laboratory if C. diff is considered to be a possible cause of your diarrhoea. The test results may show that you have a CDI or they may show that you are a C. diff carrier. If you are told you are a C. diff carrier but do not have an infection you are still infectious to others while you have diarrhoea. The precautions used for a CDI may still be put in place for a carrier experiencing diarrhoea to prevent the spread of C. diff to others. If your CDI is diagnosed while you are a patient of this Trust you will be given a CDI alert card (credit card size) for you to carry in your 3

4 wallet or purse. This is part of an initiative to raise awareness of C. diff to other healthcare providers looking after you. How is C. diff spread? Although some people are healthy carriers of C. diff, people are generally only infectious to others during episodes of diarrhoea. The C. diff bacteria are released in the diarrhoea. They can then form a protective covering making them into spores (seeds) which are able to survive in the environment for many months, even years. Equipment, furniture and toilets can become contaminated (covered) with these spores. You can acquire C. diff by touching contaminated equipment or furniture and then touching your mouth. C. diff can also be spread from person to person via contaminated hands. For most healthy people acquiring C. diff may not develop into a CDI, as the normal good gut bacteria will keep it in check. The risk is higher in some more vulnerable people whose normal gut bacteria have been disrupted. The risk for disease increases in patients with the following: Antibiotic exposure Bowel surgery Long length of stay in healthcare settings A serious underlying illness Immune-compromising conditions Advanced age. C. diff infection seems to be more common in people over 65 years of age and those taking proton pump inhibitor medicines (such as Omeprazole or Lansoprazole). You can also get C. diff more than once. There is a known risk of the return of symptoms (diarrhoea) in about per cent of patients. 4 Clostridium difficile

5 Going home from hospital Normally it is advised that you wait until the diarrhoea has settled for at least 48 hours and that your doctor is satisfied that you are fit enough to go home. You will be advised if you need to continue any treatment at home. If your symptoms come back following your discharge from hospital please contact your General Practitioner (GP) for advice. Please also use the following good practices: Wash your hands with soap and warm water after using the toilet and before handling food or medicines Machine wash soiled linen / clothing separately from other household laundry on the hottest wash suitable for the linen / clothing Keep the toilet seat and bowl, flush handles, taps and wash hand basins clean using your normal household cleaning products. Follow the manufacturers advice, particularly if you use bleach solutions Do not share personal items such as towels and face cloths Anyone helping you with personal care should wash their hands with warm water and soap when they have finished helping you. Should I tell others I have C. diff? It is helpful to inform any other healthcare professionals e.g. dentist, care home manager, community nurse, who may need to be involved in your care so that they can take any necessary precautions. This should not affect treatment in any way. If you have been given a CDI alert card please show this to any other healthcare professionals e.g. dentist, care home manager, community nurse. 5

6 Hand washing technique On the next page is an illustration showing a good handwashing technique as practised by healthcare professionals. Step 1: Wet your hands and apply soap Follow steps 2 8 in the following illustration Then dry your hands thoroughly. 6 Clostridium difficile

7 2 3 4 Rub hands palm to palm Rub back of each hand with the palm of other hand with fingers interlaced Rub palm to palm with fingers interlaced Rub with backs of fingers to opposing palms with fingers interlaced Rub each thumb clasped in opposite hand using rotational movements Rub tips of fingers in opposite palm in a circular motion 8 Rub each wrist with opposite hand 7

8 This information is correct at the time of publishing Last Reviewed: May 2013 get approved We are a smokefree organisation WZT766/DP7322/10589/05.13