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How Long Is C diff Contagious for? 6 Prevention Tips

How Long Is C diff Contagious for?

How Long Is C diff Contagious for?

As long as you have C diff, you are contagious and are producing spores that can be spread into your surrounding environment . Healthy people can get colonized by Clostridium difficile but do not necessarily get the disease. C diff occurs with antibiotic use because it wipes out competing gut microbes which gives C diff the room and resources to grow.

Therefore, you can be in contact with someone with an active C. difficile infection and not get C. diff if you have a healthy immune system and gut microbiome.

So how is c diff spread from person to person?  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. Once colonized, you are at a higher risk for C. diff infection.

Here are the risk factors for developing a C diff infection: 

1. Antibiotic Use 

Antibiotics lower the number of probiotics (good bacteria) in your gut allowing the opportunity for C. diff to take over your gut.

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.

    Once established in the gut, C. diff can secrete toxins that wear down the intestinal lining. As these toxins destroy healthy cells, they leave patches of inflammatory cells, known as plaques, along with cellular debris within the large intestine, resulting in inflammation, diarrhea, and other symptoms.4

    What are the antibiotics that cause C diff?

    The antibiotics that may most commonly result in C. diff infections include:

    • Clindamycin
    • Cephalosporins
    • Fluoroquinolones
    • Metronidazole
    • Penicillin4

      A more aggressive strain of C. diff has emerged since 2000. This new strain produces more toxins and may be resistant to common antibiotics. It has even appeared in those who have not been to the hospital or taken antibiotics.4

      2. Immunocompromised

        Those with chronic diseases that weaken the immune system make it harder for your body to fight against C diff. Without their natural immunities, the immunocompromised are much more susceptible to infections in general, even more so when they are hospitalized or in a community. Studies show that hematology and oncology patients with suppressed immune systems have a C. diff incidence rate of 6 to 33 percent. That incidence rate is up to 23 percent among lung transplant patients. Patients with HIV have an incidence rate of 7.1 to 8.3 cases for every 1,000 patient years.7

          3. Elderly

          The elderly have weaker immune systems and are less able to fight against infectious diseases. As you age, your immune system naturally gets weaker. This may also be combined with an increased use of antibiotics in old age as well as more frequent exposure to health care. Epidemiological studies suggest that about two out of every three health care-related cases of C. diff infection occur in patients who are at least 65 years of age. This same age group is also more likely to experience recurrent cases of C. diff infection.8

          4. Hospitalization or Residing in a Nursing Home

          C diff infections acquired from nursing homes and hospitals are called nosocomial infections. C. diff spreads particularly well in nursing homes, which often have the highest concentrations of the bacteria because of the large number of patients treated with antibiotics. C. diff is common in nursing homes and long-term care facilities due to the higher number of elderly patients combined with the communal living situation. The prevalence of recurrent infections and carriers who are asymptomatic increases the risk. Often the best way to prevent the spread of C. diff involves more stringent infection control measures and reducing the use of unnecessary antimicrobial and antibiotic medications.9

          5. Use certain medications that make it easier for C diff to make it past the stomach

          Although antibiotics are the most common contributor to C. diff, other medications can potentially make it easier for the bacteria to grow and spread. Proton-pump inhibitors reduce your body's production of stomach acid. The less acidic stomach is not able to kill microbes as well which then get passed into the gut. Some common antacids and antihistamines, including ranitidine, famotidine, and cimetidine, have a similar effect of reducing stomach acids and may also contribute to C. diff infections. Sucralfate, a medication prescribed for treating and preventing ulcers in the intestines, works by coating an ulcer to protect it as it heals, but the medication also acts as an antacid.10

          What Does C. Diff Look Like?

          C. diff poop often appears as severe diarrhea that occurs frequently. It’s not uncommon for those with C. diff to have loose, watery stools at least three times per day. The stools may appear to have blood or pus. Although odor is not the only deciding factor, the C. diff smell is unique. Many describe it as “sickeningly sweet,” often likened to horse manure.11

          How Long Does C diff Live on Surfaces?

            C. diff spores are known to survive on surfaces for up to five months. Contact with contaminated surfaces may result in you unknowingly ingesting C. diff spores which then colonize your gut. Make sure you wash your hands, especially before meals, and consider using a cleaner that kills C diff spores like bleach.

            Being colonized with C diff spores does not mean you have C diff. To have a C diff infection you have to be colonized by C. diff spores and have compromised gut flora.

            Antibiotic usage will compromise your gut flora because it kills good gut bacteria that keeps C diff at bay. However, C. diff can occur in 5-10 percent of patients without antibiotic use.2

            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 if it has progressed to toxic megacolon to remove the infected part of the colon. 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. About 25 percent of patients treated for C. diff have a reoccurrence within 30 days.

            Can You Recover from C Diff without Antibiotics?

            In certain cases you can recover from C diff without antibiotics. Patients require a systemic antibody, anti-toxin regimen to prevent recurring C. diff.1

            Recurrent C. diff may require further courses of antibiotics, though the effectiveness of antibiotic therapy will subside with each subsequent recurrence.

            1. Fecal Transplant: A doctor may also suggest a fecal microbiota transplant. This is an experimental alternative strategy that involves placing a donor’s stool into your large intestine via a colonoscope or nasogastric tube, which may help to restore gut bacteria to healthy levels. This procedure still requires further study, though initial trials suggest that fecal microbiota transplants performed once or twice results in a success rate of at least 85 percent.4

            2. Probiotics: Furthermore, probiotics containing S. boulardii such as Nexabiotic® Advanced can help lower chances of C. diff reoccurrence. In a meta-review, researchers evaluated studies investigating the use and effectiveness of S. boulardii in preventing C. diff. The researchers identified four studies that suggest S. boulardii may be effective in preventing recurring C. diff infections, particularly when used concurrently with antibiotics.5 Studies in rodents suggest that S. boulardii releases a protease that actually digests toxins produced by C. diff. These studies suggest the potential of S. boulardii protease to effectively attenuate the effects of C. diff toxins in the human colon.6

              C. diff Precautions

                1. Probiotics: To help with recovery, consider taking probiotics with antibiotics. Probiotics are good bacteria that make up the normal gut flora. Ask your doctor if it is okay to take probiotics with your antibiotics. Taking probiotics will reduce the chances of C diff reoccurrence. Take a reputable, high-quality multi-probiotic with a variety of strains. Ensure that it has the probiotic S. boulardii.

                  2. Test:

                  If you have severe diarrhea and recently took antibiotics, consult with your physician to get tested.

                    3. Isolate:

                    Patients with C. difficile should be put on isolation precautions to prevent the spread of infection.

                      4. Protect:

                      Visiting someone with C diff: Wear proper personal protective equipment such as gloves around patients with C. difficile. If you are in contact with a patient with C. difficile, you may be contaminated with spores on your clothes and other belongings. Therefore, personal items should be put into a plastic bag while in the room. Before leaving the room, remember to wash your hands thoroughly to prevent spreading the bacteria. Remember that hand sanitizer doesn't kill C. difficile.

                        5. Wash:

                        Handwashing cannot be stressed enough. Patients and health care workers should thoroughly wash their hands using soap and warm water. Any visitors should also wash their hands in soap and warm water before entering the room and after leaving, as well as whenever they use the restroom.

                          6. Decontaminate:

                          C. diff spores can persist in a room for several weeks or months. Disinfect C. difficile patient room and bathroom surfaces with bleach. C. diff spores can survive exposure to most common cleaning products that do not contain bleach.

                             Although C. diff is contagious, 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.


                            Next article: The Best Diet for a Faster Recovery from C diff 


                            3. David A. Burns, John T. Heap, Nigel P. Minton. “Clostridium difficile spore germination: an update”. Research in Microbiology. Volume 161, Issue 9. 2010. 730–734.