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Risk factors
By Mayo Clinic staffThe majority of C. difficile cases occur in health care settings, 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.
Although people — including children — with no known risk factors have gotten sick from C. difficile, your risk is greatest if you:
- Are now taking or have recently taken antibiotics. The risk goes up if you take broad-spectrum drugs that target a wide range of bacteria, use multiple antibiotics or take antibiotics for a prolonged period.
- Are 65 years of age or older. The risk of becoming infected with C. difficile is 10 times greater for people age 65 and older compared with younger people.
- Are now or have recently been hospitalized, especially for an extended period.
- Live in a nursing home or long term care facility.
- Have a serious underlying illness or a weakened immune system as a result of a medical condition or treatment (such as chemotherapy).
- Have had abdominal surgery or a gastrointestinal procedure.
- Have a colon disease such as inflammatory bowel disease or colorectal cancer.
- Have had a previous C. difficile infection.
References
- Kelly CP, et al. Treatment of antibiotic-associated diarrhea caused by Clostridium difficile in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2010.
- Bartlett JG. Narrative review: The new epidemic of Clostridium difficile-associated enteric disease. Annals of Internal Medicine. 2006;145:758.
- Pepin J, et al. Clostridium difficile-associated diarrhea in a region of Quebec from 1991 to 2003: A changing pattern of disease severity. Canadian Medical Association Journal. 2004;171:466.
- Kelly CP, et al. Clostridium difficile — More difficult than ever. New England Journal of Medicine. 2008;359:1932.
- LaMont JT. Clinical manifestations and diagnosis of Clostridium difficile infection in adults. http://www.uptodate.com/home/index.html. Accessed Sept. 28, 2010.
- Efron PA, et al. Clostridium difficile colitis. Surgical Clinics of North America. 2009;89:483.
- Monaghan T, et al. Recent advances in Clostridium difficile-associated disease. Gut. 2008;57:850.
- Kelly CP, et al. Antibiotic-associated diarrhea, pseudomembranous enterocolitis, and Clostridium difficile-associated diarrhea and colitis. In: Feldman M, et al. Sleisenger and Fordtan's Gastrointestinal and Liver Disease: Pathophysiology, Diagnosis, Management. 9th ed. Philadelphia, Pa.: Saunders Elsevier; 2010. http://www.mdconsult.com/books/linkTo?type=bookPage&isbn=978-1-4160-6189-2&eid=4-u1.0-B978-1-4160-6189-2..00108-6. Accessed Sept. 30, 2010.
- Bartlett JG, et al. Clinical recognition and diagnosis of Clostridium difficile infection. Clinical Infectious Diseases. 2008;46(suppl):S12.
- Bakken JS. Fecal bacteriotherapy for recurrent Clostridium difficile infection. Anaerobe. 2009;15:285.
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