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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 the hands of caregivers, 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 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 up compared with younger people.
- Are 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.
- Kelly CP, et al. Patient information: Antibiotic-associated diarrhea (Clostridium difficile). http://www.uptodate.com. Accessed Nov. 3, 2008.
- Bartlett JG. Narrative review: The new epidemic of Clostridium difficile-associated enteric disease. Annals of Internal Medicine. 2006;145:758.
- Kelly CP, et al. Treatment of antibiotic-associated diarrhea caused by Clostridium difficile. http://www.uptodate.com. Accessed Nov. 3, 2008.
- 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. http://www.uptodate.com. Accessed Nov. 3, 2008.
- Durai R. Epidemiology, pathogenesis, and management of Clostridium difficile infection. Digestive Disease Science. 2007;52:2958.
- Monaghan T, et al. Recent advances in Clostridium difficile-associated disease. Gut. 2008;57:850.
- Sunenshine R, et al. Clostridium difficile-associated disease: New challenges from an established pathogen. Cleveland Clinic Journal of Medicine. 2006;73:187.
- Information for healthcare providers. Centers for Disease Control and Prevention. http://www.cdc.gov/ncidod/dhqp/id_CdiffFAQ_HCP.html. Accessed March 2, 2009.
- Centers for Disease Control and Prevention, et al. Guideline for hand hygiene in health-care settings. MMWR Recommendations and Reports. 2002;51:RR-16. http://www.cdc.gov/mmwr/PDF/rr/rr5116.pdf. Accessed March 2, 2009.
