A well-deserved name
Clostridium difficile (also known as C. diff) secretes a toxin that attacks the lining of the colon, causing watery diarrhea and varying levels of abdominal pain and cramping. Serious infections can lead to dehydration, bloody stool, weight loss, kidney failure, and sometimes death. C. diff is more common in hospitals and nursing homes, especially among the elderly and in people who've recently taken antibiotics. And it can be very hard to clear up; recurrent infections are common after treatment, and newer, harder-to-treat strains are emerging. For these reasons, prevention is the key to limiting the spread of this tenacious infection.
Good bugs vs. bad bugs
Probiotics are defined as "live microorganisms which when administered in adequate amounts confer a health benefit on the host." One of the best-known examples is Lactobacillus acidophilus.
Several studies have suggested that probiotics are beneficial for colon health and may reduce the chances of acquiring antibiotic-associated diarrhea.
The study pooled the results of 23 trials including 4,213 participants of all ages being treated with antibiotics to see what effect probiotics had on C. diff-associated diarrhea, C. diff infection, other antibiotic-associated diarrhea, and adverse events such as abdominal cramping, nausea, and gas.
Here's what the review showed:
Probiotics reduced the risk of C. diff-associated diarrhea by 64%.
Compared with placebo or no treatment, probiotics significantly decreased adverse events, including abdominal cramping, nausea, fever, soft stools, gas, and taste disturbance.
Probiotics significantly reduced the risk of antibiotic-associated diarrhea caused by organisms other than C. diff.
The risk of C. diff infection wasn't affected by probiotic use.
"The possibility therefore arises that probiotics may be effective in preventing symptoms of infection or in limiting the extent of infection rather than inhibiting the colonization and infection itself," commented lead researcher, Joshua Goldenberg of Bastyr University, on this last finding.
Preventing C. diff
Since one of the biggest risk factors for contracting C. diff is taking antibiotics, it follows that avoiding unnecessary antibiotic use can help decrease risk.
C. diff can be found on bedrails, sink faucets, door handles, call buttons, IV poles, and any other place that an infected person touches after contact with the feces. Once it's on these surfaces and another person touches one of them, it's only a matter of time until the bacteria make it to the mouth of that person (such as during eating, covering a cough, or touching the lips).
For healthcare workers and those in hospitals or nursing facilities, good hygiene is the key to limiting C. diff transmission. The bacteria are spread by the fecal-oral route (from the feces of an infected person to the mouth--and subsequently the intestines--of a noninfected person), so good hand washing is crucial for preventing spread of the infection.
A cleaning solution containing bleach should be used to thoroughly disinfect all surfaces that have come in contact with a C. diff-infected person.
(Cochrane Database Syst Rev 2013;DOI:10.1002/14651858.CD006095.pub3)