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Risk factors

By Mayo Clinic staff

Although people — including children — with no known risk factors have gotten sick from C. difficile, certain factors increase your risk.

Taking antibiotics or other medications
Medication-associated risk factors include:

  • Currently taking or having recently taken antibiotics
  • Taking broad-spectrum antibiotics that target a wide range of bacteria
  • Using multiple antibiotics
  • Taking antibiotics for a long time
  • Taking medications to reduce stomach acid, including proton pump inhibitors (PPIs)

Staying in a health care facility
The majority of C. difficile cases occur in, or after exposure to, health care settings — including hospitals, nursing homes and long-term care facilities — where germs spread easily, antibiotic use is common and people are especially vulnerable to infection. In hospitals and nursing homes, C. difficile spreads mainly on hands from person to person, but also on cart handles, bedrails, bedside tables, toilets, sinks, stethoscopes, thermometers — even telephones and remote controls.

Having a serious illness or medical procedure
If you have a serious illness, such as inflammatory bowel disease or colorectal cancer, or a weakened immune system as a result of a medical condition or treatment (such as chemotherapy), you're more susceptible to a C. difficile infection. Your risk of C. difficile infection is also greater if you've had abdominal surgery or a gastrointestinal procedure.

Older age is also a risk factor for C. difficile infection. In one study, the risk of becoming infected with C. difficile was 10 times greater for people age 65 and older compared with younger people.

After having a previous C. difficile infection, your chances of having a recurring infection can be up to 20 percent, and the risk increases further with every subsequent infection.

Complications Causes
References
  1. Khanna S, et al. Clostridium difficile infection: New insights into treatment. Mayo Clinic Proceedings. 2012;87:1106.
  2. Rebmann T, et al. Preventing Clostridium difficile infections: An executive summary of the Association for Professionals in Infection Control and Epidemiology's elimination guide. American Journal of Infection Control. 2011;39:239.
  3. LaMont JT. Clostridium difficile in adults: Epidemiology, microbiology, and pathophysiology. http://www.uptodate.com/home. Accessed March 25, 2013.
  4. Kelly CP, et al. Clostridium difficile in adults: Treatment. http://www.uptodate.com/home. Accessed March 25, 2013.
  5. Frequently asked questions about Clostridium difficile for healthcare providers. Centers for Disease Control and Prevention. http://www.cdc.gov/HAI/organisms/cdiff/Cdiff_faqs_HCP.html. Accessed March 25, 2013.
  6. Headley CM. Deadly diarrhea: Clostridium difficile infection. Nephrology Nursing Journal. 2012;30:459.
  7. LaMont JT. Clostridium difficile in adults: Clinical manifestations and diagnosis. http://www.uptodate.com/home. Accessed March 25, 2013.
  8. Surawicz CM, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. The American Journal of Gastroenterology. In press. Accessed March 25, 2013.
  9. Armstrong GD, et al. A potential new tool for managing Clostridium difficile infection. The Journal of Infectious Diseases. In press. Accessed March 25, 2013.
  10. Venugopal AA, et al. Current state of Clostridium difficile treatment options. Clinical Infectious Diseases. 2012;55:S71.
  11. Vancomycin hydrochloride. Micromedex Healthcare Series. http://www.micromedex.com. Accessed March 27, 2013.
  12. Fidaxomicin. Micromedex Healthcare Series. http://www.micromedex.com. Accessed March 27, 2013.
  13. Van Nood E, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. New England Journal of Medicine. 2013;368:407.
  14. Diarrhea. National Digestive Diseases Information Clearinghouse. http://digestive.niddk.nih.gov/ddiseases/pubs/diarrhea/#treated. Accessed March 27, 2013.
  15. Clostridium difficile and C. difficile toxin testing. Lab Tests Online. http://labtestsonline.org/understanding/analytes/cdiff/tab/test. Accessed April 15, 2013.
  16. Public workshop: Fecal microbiota for transplantation. U.S. Food and Drug Administration. http://www.fda.gov/BiologicsBloodVaccines/NewsEvents/WorkshopsMeetingsConferences/ucm341643.htm. Accessed April 15, 2013.
  17. Steckelberg JM (expert opinion). Mayo Clinic, Rochester, Minn. April 16, 2013.
  18. Khanna S, et al. The epidemiology of community-acquired Clostridium difficile infection: A population-based study. The American Journal of Gastroenterology. 2012;107: 89.
  19. Khanna S (expert opinion). Mayo Clinic, Rochester, Minn. April 17, 2013.
DS00736 July 16, 2013

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