Clostridium difficile infection (CDI) has become more and more prevalent in the past 15 years, and a particularly virulent strain has killed up to 15 percent of patients infected with it. The Centers for Disease Control and Prevention has labeled CDI “an urgent threat.” Here’s what you need to know about CDI and what you can do to protect yourself.
CDI presents with intractable diarrhea and often leads to dehydration and nutritional depletion that requires hospitalization. CDI is considered to be especially dangerous in the very young, the very old, and those who have a compromised immune system due to diseases or chemotherapy drugs.
Prevention of CDI begins with an awareness of risk factors. Antibiotic overuse and the development of “superbugs”—bacteria that are resistant to many medications—is the main cause. Contact with individuals with the infection is another common cause of transmission. As a patient, avoid using antibiotics unless infections are life-threatening or there is very clear evidence that the infection is bacterial. There is a common misconception that viral infections can be treated with antibiotics, but this is not true. Antibiotics do not eradicate viruses, which are the most common respiratory pathogens (for example, they are the primary cause of the common cold).
Contact with individuals who have CDI is another common cause of transmission. If you are visiting a hospitalized patient, be sure to wash your hands thoroughly and frequently, and make sure that all surfaces are cleaned with a solution that contains bleach. Patients with CDI should be isolated from other patients at all times.
Early identification and treatment of CDI are key for reducing the risk of serious complications. Fortunately, a stool test can easily detect C. diff. If you develop ongoing diarrhea and have used antibiotics within the past two months, seek medical care, ask for a test for C. diff, and make a concentrated effort to stay hydrated.
Several newer antibiotic agents have been tested for the prevention of CDI for patients that need antibiotic treatment, such as those undergoing certain surgeries or procedures. If you require a course of antibiotics, ask your doctor whether these agents would be appropriate in your case. And, if you have previously had CDI, be sure to inform all of your healthcare providers. As always, prevention and early detection save lives.
—Editor-in-Chief Orli R. Etingin, MD
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