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Clostridioides difficile infection
What is Clostridioides difficile infection and what are the symptoms?
Clostridioides difficile (C. diff) bacteria usually live harmlessly in your gut alongside lots of other types of bacteria. When the balance of this gut bacteria (microbiome) is disturbed, it can cause an infection.1
Clostridioides difficile infection (CDI) is the most common cause of infectious hospital-onset diarrhoea1, There were 14,249 CDI cases reported in England between April 2021 and March 2022.2
Risk factors for CDI
A number of risk factors have been identified for developing CDI:1
Previous CDI episode
A weakened immune system
Over 65 years of age
Taking, or recently taken, broad spectrum antibiotics
Taking a proton pump inhibitor (PPI)
Stay in hospital or care home for a long time
Recurrence
Most recurrences of CDI happen within 30 days of completing anti-CDI treatment and may be a resumption of the initial infection or through new exposure to C. diff bacteria.3
The risk of CDI recurrence increases with each episode4
Symptoms of Clostridioides difficile infection (CDI) include: 1
Watery diarrhoea several times a day
- A high temperature
- A loss of appetite
- Feeling sick
- Stomach pain
- Signs of dehydration
Diagnosing CDI
A healthcare professional will likely perform a series of tests to determine if a patient has CDI, this will require the patient to provide a stool sample.1
Characteristics of CDI
During an infection, C. difficile can produce toxins and spores. C. difficile spores are extremely difficult to get rid of – they can survive in extreme environmental conditions including heat, disinfectants & many antibacterial soaps and hand gels.5, 6
Someone with CDI can easily pass the infection on to others due to contamination of the environment.
Toxins
These are responsible for the symptoms felt by a CDI patient and can cause tissue damage.7
Spores
These are inactive C. diff bacteria cells which are responsible for the persistence
and recurrence of C. difficile infections in patients.7
To reduce the spread of disease, it is important that people with CDI:1
- Stay at home until at least 48 hours after diarrhoea has stopped
- Regularly wash hands using soap and water
- Use bleach or hypochlorite-based disinfectant to clean the toilet and the area around it after each use
- Wash clothes and bedding separately from that of others and on the highest recommended temperature setting
- Avoid sharing towels and flannels
- Avoid taking medicines intended to stop diarrhoea, such as loperamide
Want to learn more?
The C.Diff Trust offers a wide range of information and support for people affected by Clostridioides difficile infection. Please click here to visit their website for
further information.
References
1.NHS (2022). Clostridium difficile infection. nhs.uk/conditions/c-difficile [Accessed February 2024]
2.UK Health Security Agency. (2023) 30 day all-cause mortality following MRSA, MSSA and Gram-negative bacteraemia and C. difficile infections: 2021 to 2022 report. Available at: gov.uk/c-difficile-infections-2021-to-2022-report [Accessed February 2024]
3. Kelly, C. Clin Microbiol Infect 2012;18(Suppl. 6):21-27.
4. Tsigrelis C. Cleveland Clinic Journal of Medicine 2020;87(6):347-359.
5.Babakhani F, et al. Clinical Infectious Diseases 2012;55(S2):S162-169.
6.Heinlen L and Ballard J. Am J Med Sci 2010; 340(3): 247–252.
7. Zhu D, et al. Frontiers in Cellular and Infection Microbiology 2018;8(29):1-10.
NU-02824 | April 2026
