C. difficile infection

Diagnosis

A C. difficile infection is determined by the existence of:

• Diarrhea
• Detection of C. difficile in stool
• Other C. difficile infection signs and symptoms

Testing for C. difficile infection should not be done on those who have regular, well-formed feces. It is not necessary to have recently taken antibiotics in order to diagnose C. difficile infection.

Stool tests

Your doctor will request one or more stool sample laboratory tests if C. difficile infection is suspected. These tests either pinpoint the toxin or the bacterial strains that create it.

Colon examination

In certain cases, a doctor may conduct an internal examination of your colon to confirm a diagnosis of C. difficile infection and to investigate other potential causes of your symptoms. This examination, also referred to as a flexible sigmoidoscopy or colonoscopy, involves inserting a flexible tube with a small camera on one end into your colon. The purpose of this procedure is to examine the colon for any abnormal tissue or inflammatory lesions that may provide further insights into your condition.

Imaging tests

Your doctor might request an abdominal X-ray or a computerized tomography (CT) scan, which produces images of your colon, if they are worried about potential C. difficile infection consequences. The scan has the ability to identify issues like:

• Bowel enlargement
• Perforation in your colon’s lining
• Colon wall thickening

Treatment

Treatment is administered only to individuals who show signs or symptoms of illness. Those who have the bacterium but are otherwise healthy and do not exhibit any symptoms are not given any treatment.

Antibiotics

If your C. difficile infection is linked to the antibiotic you are taking, your doctor will likely discontinue its use. However, in cases where antibiotic therapy is necessary to treat another infectious disease, your doctor may prescribe an alternative medication that is less likely to cause diarrhea triggered by C. difficile infection.

The primary treatment for C. difficile infection involves the use of antibiotics. Commonly prescribed antibiotics for this condition include fidaxomicin and vancomycin. In cases of severe C. difficile infections, a combination of vancomycin and metronidazole can be utilized for treatment.

Surgery

In some circumstances, including the following, surgery to remove the diseased part of the colon may be required.

• Organ failure
• Toxic megacolon
• Extreme pain
• The abdominal wall lining is inflamed

Treatment for recurrent infection

A quarter of those who have had C. difficile infections treated get sick again, either because the original infection persisted or because they have been exposed to a new strain of the bacteria. With each bout of C. difficile infection, the risk rises, exceeding 50% after three or more infections.

If any of the following apply to you:

• Age more than 65
• Have a major underlying illness, like inflammatory bowel disease, chronic liver disease, or chronic kidney failure.
• Are receiving treatment for a C. difficile infection while also taking antibiotics for a separate disease.

The following methods may be used to treat recurrent illness.

• Antibiotics. One or more courses of a medicine may be used as part of an antibiotic therapy regimen for recurrent infections. The medications are typically not the same kind of antibiotics that were previously utilized. With each consecutive recurrence, antibiotic therapy becomes less effective.
• Antibody-based therapy. Human antibody against the C. difficile toxin B, bezlotoxumab, is a treatment that has been found to lower the risk of recurrent C. difficile infection in people who are at a high risk of recurrence.
• Fecal Microbiota Transplant (FMT). FMT has been researched in clinical trials as a potential treatment for many recurring C. difficile infections. Although the U.S. Food and Drug Administration has not approved FMT, it may be used as an experimental technique for C. difficile infection. You must sign a consent form that details the procedure’s advantages and disadvantages. FMT is often referred to as an intestinal microbiota transplant or a stool transplant.

By using specialized tubes that are introduced via your rectum, FMT replaces healthy intestinal bacteria in your colon. Before being utilized for FMT, donors are rigorously screened for medical issues, their blood is examined for infections, and their feces are checked for parasites, viruses, and other infectious germs.

According to studies, FMT performed once or more times has a greater than 85% success rate in treating recurrent C. difficile infections.

• Probiotics. Probiotics, which are supplements or foods containing beneficial microorganisms, are intended to support the stability and growth of the body’s “good” bacteria. However, their role in contributing to C. difficile infections remains a subject of debate. The effectiveness of existing probiotic products in preventing or treating C. difficile infections has not been consistently demonstrated through research. While advanced probiotics are still under investigation, they are not currently available for the treatment or prevention of C. difficile infections. Researchers continue to explore their potential utility in this regard.