Its usual habitat is the large intestine, where there is very little oxygen. It can be found in low numbers in a small proportion (less than 5%) of the healthy adult population. It is kept in check by the normal, 'good' bacterial population of the intestine. It is common in the intestine of babies and infants, but does not cause disease because its toxins (poisons) do not damage their immature intestinal cells.
Although C. difficile was first described in the 1930s, it was not identified as the cause of diarrhoea and colitis following antibiotic therapy until the late 1970s.
What does C Dif cause?
C. difficile can cause diarrhoea, ranging from a mild disturbance to a very severe illness with ulceration and bleeding from the colon (colitis) and, at worst, perforation of the intestine leading to peritonitis. It can be fatal.
Generally, it is only able to do this when the normal, healthy intestinal bacteria have been killed off by antibiotics. When not held back by the normal bacteria, it multiplies in the intestine and produces two toxins (A and B) that damage the cells lining the intestine. The result is diarrhoea.
Who gets C. difficile infection?
Patients who have been treated with broad spectrum antibiotics (those that affect a wide range of bacteria, including intestinal bacteria) are at greatest risk of C. difficile disease. Most of those affected are elderly patients with serious underlying illnesses. Most infections occur in hospitals (including community hospitals), nursing homes etc, but it can also occur in primary care settings.
How does C. difficile spread?
Although some people can be healthy carriers of C. difficile, in most cases the disease develops after cross infection from another patient, either through direct patient to patient contact, via healthcare staff, or via a contaminated environment. A patient who has C. difficile diarrhoea excretes large numbers of the spores in their liquid faeces. These can contaminate the general environment around the patient's bed (including surfaces, keypads, equipment), the toilet areas, sluices, commodes, bed pan washers, etc. They can survive for a long time and be a source of hand-to-mouth infection for others. If these others have also been given antibiotics, they are at risk of C. difficile disease.
How is C Dif diagnosed?
A sample of diarrhoeal faeces is tested for the presence of the C. difficile toxins. This is the main diagnostic test and gives a result within a few hours. In outbreaks, or for surveillance of the different strains circulating in the population, C. difficile can be cultured from faeces and the isolates sent to the Anaerobe Reference Laboratory (National Public Health Service, Wales; Microbiology, Cardiff) for typing and testing for susceptibility to antibiotics.
How common is C Dif?
When C. difficile was first recognised to cause antibiotic-associated diarrhoea and colitis in the late 1970s, laboratory diagnosis was difficult and the number of cases was not monitored. Since 1990 laboratories have reported the number of cases diagnosed to the Health Protection Agency in a voluntary system. The number of reports increased from less than 1,000 in the early 1990s to 22,000 in 2002, 28,000 in 2003 and 44,488 in 2004. Some of this was due to improved diagnostic tests and improved reporting by laboratories, but there has clearly been a very significant increase in the number of cases. Since January 2004, C. difficile has been part of the mandatory surveillance programme for healthcare associated infections.
C Dif Prevention and control
There are three important components to the prevention and control of C. difficile disease:
- prudent antibiotic prescribing to reduce the use of broad spectrum antibiotics
- isolation of patients with C. difficile diarrhoea and good infection control nursing
- handwashing (not relying solely on alcohol gel as this does not kill the spores)
- wearing gloves and aprons, especially when dealing with bed pans etc
- enhanced environmental cleaning and use of a chlorine containing disinfectant where there are cases of C. difficile disease to reduce environmental contamination with the spores.
WHAT CAN I CLAIM FOR?
Generally, compensation for general damages for pain, discomfort and loss of amenity will vary depending on the severity of symptoms / condition and the period of time for which they have or are likely to last. The greater the level of pain and discomfort and the longer the symptoms persist, the higher the compensation.
In addition to general damages, you may also claim for all heads of Special Damages, to include past and future loss of earnings; overtime; bonus pay; gratuitous care provided by family / friends ; travel expenses; payments for painkillers; private medical treatment; pension loss; etc
Strict time limits may apply within which you may make a claim and generally, any delay increases difficulties.
HOW TO CLAIM FOR C DIF INFECTION:
If you believe there is a possible CDif compensation claim either for yourself or a loved one, then just complete the form on your right and our friendly and sympathetic UK claim team will be able to advise you on whether or not you have a genuine No Win No Fee claim for compensation.
Claim Compensation
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