Sepsis and C. Difficile (C. diff)

Clostridioides difficile, often called C. difficile or C. diff., is a bacteria spread by microscopic spores.  It used to be called Clostridium difficile. The bacteria cause inflammation of the gut or colon – colitis. This can lead to moderate-to-severe diarrhea, and sometimes sepsis, which can develop as the body tries to fight the infection.

Sepsis, which was often called blood poisoning, is the body’s life-threatening response to infection. Like strokes or heart attacks, sepsis is a medical emergency that requires rapid diagnosis and treatment. Worldwide, one-third of people who develop sepsis die. Many who survive are left with life-changing effects, such as post-traumatic stress disorder (PTSD), chronic pain and fatigue, organ dysfunction (don’t work properly), and/or amputations.

Most C. difficile infections occur in hospitals or healthcare facilities. These are called healthcare-acquired infections, or HAIs. However, physicians are finding that more and more, people are coming into contact with the bacteria in the community.

Suggested Citation:
Sepsis Alliance. Sepsis and C. difficile. 2023. https://www.sepsis.org/sepsisand/c-difficile/

Updated November 22, 2023.

 

More About C. Diff

Transmission

The Clostridioides difficile bacteria are found in stool (fecal matter), and spread from person to person through direct and indirect contact.

Not everyone who has the bacteria becomes ill, however. It is possible to spread the infection unknowingly.

Direct contact: Someone who has the bacteria on their hands touches someone else, transferring the germs to the other person.

Indirect contact: The bacteria can stay alive for quite a while on surfaces, such as bedside tables, elevator buttons, doorknobs, telephones, and even clothing. People with the bacteria on their hands touch these objects. Others then touch them, transferring the bacteria to their own hands.

Symptoms
  • Watery diarrhea (at least three bowel movements per day for two or more days). Diarrhea caused by C. difficile has as particular odor.
  • Fever
  • Decrease or loss of appetite
  • Nausea
  • Abdominal pain, bloating, tenderness.

If the infection progresses and becomes more severe, there may also be:

  • Dehydration
  • Weight loss
Risk Factors

People who are in hospitals or other healthcare settings are at highest risk of developing C. difficile infections. Others are those who:

  • Are over 65 years
  • Have serious illnesses, particularly those that can weaken the immune system
  • Are taking or who have recently taken antibiotics
  • Are taking medications to manage stomach acid, including those known as proton pump inhibitors (PPIs)
  • Have had previous C. difficile infections.

The only way to prevent developing an infection with C. difficile is by avoiding exposure to the bacteria. The most effective method to do this is by frequent and proper hand washing with soap and water by everyone: patients, visitors, and anyone who works in the healthcare facilities. Waterless hand cleaners do not adequately kill C. difficile.

Patients who havePatients who have C. difficile infection should be isolated from other patients to avoid spreading the bacteria. Healthcare workers who enter isolation rooms have to wear gloves and gowns.

Reducing antibiotic overuse also reduces the risk of C. difficile infection. This means not asking for antibiotics for viral infections (like colds and the flu) and not taking someone else’s medications.

Treatment

Doctors use specific antibiotics to treat C. difficile, but recommendations vary according to the severity of the infection, how often a patient has had the infection, and the availability of the recommended antibiotics. There are also newer treatments such as those that involve transplanting healthy fecal matter into the infected person’s gut. To learn about the most up-to-date research into treatments, visit the CDC page on C. diff.

In severe cases, a surgeon may need to remove the affected part of the colon.

The CDC reports that about 20% of people experience a recurrence of C. difficile infection, sometimes repeatedly. However, testing with FMT is showing a high success rate in eliminating the infection altogether.

The Sepsis and C. Difficile section has been developed in partnership with the C. Diff Foundation.

Related Resources

Information Guide

C. difficile

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Information Guide

Bacterial Infections

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Robert Helton

In February 2021 I received care from a neighborhood physician’s assistant for a hangnail that had become infected. After having the infection drained, I was prescribed an antibiotic. Two weeks later I became ill with severe diarrhea and returned to the same office. (Sepsis and Bacterial Infections) I was prescribed Cipro and Flagyl for potential diverticulitis and my symptoms subsided. Another two weeks passed and again, I was sick again with the same symptoms and visited my primary care physician and was again prescribed Cipro and Flagyl and the physician’s assistant also ordered a CT scan that later revealed irritation ... Read Full Story

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Mary Raich

I had gone to Florida with friends for a girls weekend. I felt fine when we left. The next morning I woke up not feeling well and stayed in bed all day and night. At 5am I woke up to use the bathroom and passed out. My friends called 911. My pulse oxygen was 84. I had severe diarrhea, extremely low blood pressure and a lot of pain. Doctors admitted me to the ICU with C-diff, sepsis and septic shock. (Sepsis and C. Difficile, Sepsis and Septic Shock) My kidneys and liver where failing and they were struggling to keep ... Read Full Story

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A. Hamon

My mother died from sepsis on April 12, 2023, following being in the hospital the week before. She contracted the C. difficile, which caused sepsis. (Translated from French, original is below.)   Ma maman est décédée du sepsis, le 12 avril 2023 suite à une hospitalisation la semaine précédente elle aurait contractée la bactérie C. difficile qui c’est à terminée en septicémie. Read Full Story

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Mary Lansing

This story is about my mother Mary. She was a healthy dialysis patient. (Sepsis and Invasive Devices) She didn’t want to get an infection so she agreed to have a graft put under her skin which was safer than having a dialysis catheter. She always was careful to follow the doctor’s advice. One night after dialysis, she got up from bed to go to the bathroom. And got dizzy and fell and broke her ankle in many places. When she got to the emergency room, she was found to be septic and that was what caused her to fall. Not ... Read Full Story

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Amy May

In 2018 I was 28 weeks pregnant and started experiencing weird symptoms. I was sick all the time. I was loosing weight. I was constantly dehydrated and couldn’t keep up with my fluids. I was initially diagnosed with C.diff and was put on an antibiotic. (Sepsis and C. diff) While on that antibiotic I developed chills and fevers. I was admitted to the hospital where they drew blood cultures. 5 days later on Christmas Eve I received a phone call stating that my blood cultures had come back positive for Fusobacterium necrophorum. I was admitted at 32 weeks pregnant to ... Read Full Story

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C. Difficile (C. diff)