How Contagious is C diff?
C diff is not contagious in the normal sense where you can get it from someone with an active C diff infection. You can become colonized by C diff by consuming C diff spores which are spread through contact with fecal matter or contact with a contaminated object, including phones, door handles, and keyboards.
A person usually gets an infection from C diff after taking antibiotics. How? Many healthy people have C diff in their digestive tract. However, after taking antibiotics, C diff can multiply and cause problems. Antibiotics do not discriminate between good and bad bacteria, killing off a lot of the normal gut flora that kept Clostridium difficile bacteria in check. When the antibiotics kill off the good bacteria, C diff can multiply and take over the gut, which lead to many health problems.
The good news is that even if the C diff bacteria colonize your gut they have to increase rapidly in order to actually cause any symptoms or problems. Generally, as long as your immune system is functioning properly and you do not take any antibiotics, your body should be able to fight off C diff and prevent a full on infection. However, people who have a harder time resisting the bacteria include:
- Those with chronic diseases that weaken the immune system
- The elderly
- Individuals who have been hospitalized
How Long Does it Take to Recover from C diff?
Treatments with antibiotics usually take about 10 to 14 days, though severe infections with C diff may require intravenous antibiotics or surgery. Usually, a person is considered not contagious once all of their symptoms have subsided and doctors can detect little or no toxin in the patient’s stools. It can be hard to say for sure when C diff becomes completely non-contagious as someone who has been previously infected can have reoccurring C. diff. However, as long as you have completed your course of treatment and show no more symptoms, your chances of spreading C diff should be extremely low.13
To help with recovery, consider taking probiotics with antibiotics. Probiotics are good bacteria that help keep C diff in check.
C diff Antibiotics and Medical Treatments
The first treatment step is, if possible, to stop taking the antibiotic that triggered the C diff infection. Standard treatments include:
C diff Antibiotics:
This may sound counter intuitive but antibiotics are the mainstay for C diff treatment. The two main antibiotics for C diff are metronidazole and vancomycin. Both are bacteriostatic which keeps the diff bacteria from growing. If the infection is mild, your doctor will usually prescribe metronidazole (Flagyl). Although this antibiotic is not FDA approved for C. difficile infection, it has been shown to be an effective treatment in mild to moderate cases.1 For more severe or recurrent bouts of C. difficile infection, vancomycin (Vancomycin) is used.
Newer C diff Antibiotics
- Fidaxomicin is a bacteriocidal antibiotic which actually kills C diff. It has a narrower spectrum of activity compared to metronidazole and vancomycin so it disrupts normal gut flora less. In one study comparing fidaxomicin with vancomycin found that cure rates were similar and that reoccurrence rates with fidaxomicin were lower compared to vancomycin. However, the reoccurrence rate was not better when the patient was infected with hypervirulent strains of C diff.2
- Rifaximin is an antibiotic that is usually used in conjunction with traditional antibiotics for C diff. One study found that taking a two week course of rifaximin after the last course of vancomycin prevented reoccurences of C diff.3 However, taking repeated courses of rifaxmin has been noted to cause C diff to become resistant to rifaxmin
If your C diff infection is severe enough to cause inflammation of the colon lining, toxic megacolon, or organ failure. You may need surgery to remove the diseased section of the colon.
Fecal Transplant for C diff
A fecal microbiota transplant (FMT) involves taking fecal bacteria from a healthy person and transplanting it into a recipient. This process may be used during or after a C. diff infection, to restore healthy colonic microflora.4 There are several methods for fecal transplantation:
- Enema: patients are given an enema containing stool from a healthy donor. With an enema, probiotics can only reach the distal part of the large intestine.
- Colonoscope: The transplant is performed using a colonoscopy. A colonoscope is inserted through the rectum and the colon is irrigated with liquefied donor fecal material. The advantage of FMT performed via colonoscope is that it allows for inspection of the colon at the same time the procedure is performed. It can also reach the end of the small intestine where C diff can reside.
- Oral: The transplant is performed using an oral capsule containing freeze-dried fecal matter. One study comparing the efficacy of colonoscope FMT with FMT via capsules in 116 patients randomized to either found that rates of prevention of recurrent C diff infection were 96 percent in both groups.5
The basic concept of fecal microbiota transplant is to introduce good bacteria or probiotics into the gut. If you're not ready to undergo a fecal microbiota transplant, consider taking a probiotic supplement instead.
Next article: The c Diff Diet for Fast Recovery