Clostridium difficile associated disease (CDAD)

What is clostridium difficile?

Clostridium difficile belongs to the clostridium family of bacteria, which also includes the bacteria that cause tetanus and botulism. 

Clostridium difficile germs normally inhabit the large intestine and they can be found in less than 3% of the healthy adult population. They are more common in the intestine of babies and infants, elderly people and those in hospital. However, the germs are normally kept in check by the normal good bacteria also found in the intestine.

Clostridium difficile germs can multiply and the toxins they produce may cause severe and frequent diarrhoea, abdominal pain and fever.  In some cases, it can cause a life-threatening inflammation of the bowel. This is known as clostridium difficile associated disease or CDAD for short.

Who is most at risk of developing CDAD?

CDAD infection is most likely to develop in patients who: 

  • have been treated with antibiotics
  • are aged over 65 and have a serious illness 

How is clostridium difficile spread? 

You can become infected with Clostridium difficile by: 

  • close contact with another person infected with CDAD when they have active symptoms
  • direct contact with a microscopically-contaminated environment, particularly near someone who has CDAD; Clostridium difficile germs produce “spores” which can survive for a long time outside the body. 

Can CDAD be treated? 

In mild cases, no specific treatment is required, although antibiotic treatment may be changed or stopped.  More severe cases require treatment with specific antibiotics. 

Preventing CDAD 

To prevent CDAD we have a number of measures in place in our hospitals: 

  • controlled antibiotic prescribing
  • excellent hand hygiene systems
  • robust surveillance activity to enable early identification of CDAD
  • the facilities to nurse patients in a side room
  • regular cleaning programmes 

Other infection control measures in place 

In our hospitals we have a number of other infection control measures which limits the spread of any infections: 

  • surgical wounds and skin cuts are covered with dressings
  • patients are asked not to touch their wounds or damaged skin and to regularly wash their hands to prevent self-infection
  • people visiting patients are asked to wash their hands before and after visiting – visitors can wash their hands with soap and water at the hand wash sink, making sure they dry their hands afterwards, or they can use the alcohol hand rub provided
  • if visitors need to see more than one patient they should clean their hands before and after seeing each patient 

If you are going into hospital there are a number of basic hygiene measures that you can take yourself: 

  • keep your hands and body clean – take soap, a flannel, moist hand-wipes and your own razor into hospital
  • always wash your hands after using the toilet or commode
  • always wash your hands or clean them with a hand-wipe immediately before and after eating a meal
  • make sure that your bed area is cleaned regularly
  • report any unclean toilet or bathroom facilities to your nurse
  • ask your visitors to follow the measures listed above 





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