What is Clostridium difficile?
Clostridium difficile is a gram-positive bacterium in rod form. As with all Clostridia, it is an anaerobic bacterium, i.e. bacteria that do not tolerate or need oxygen. They are spores and can therefore survive for a long time.
Many people carry this germ in their intestines without becoming ill. However, if Clostridium difficile multiplies too much, it can lead to severe intestinal inflammation and blood poisoning. Certain antibiotics can defeat Clostridium difficile. There is a relatively high incidence of the bacterium in hospitals because it is very contagious.
Causes for the disease
For Clostridium disease to occur, the bacterium must first be present in the body. Some people, especially small children, carry Clostridium difficile permanently in the intestine without it causing disease. However, Clostridium Difficile is also highly contagious when it comes into contact with body fluids.
The bacterium or its spores can easily spread over entire hospital wards through the hands of hospital staff, which is why it is assumed to be about 40 percent infectious in hospitals. In order for the germ to colonize the hospital, there must be an internal cause for the disease to break out. One cause is a long therapy with antibiotics.
Clostridia are very resistant to many antibiotics. The normal intestinal flora is therefore destroyed by the antibiotic and the Clostridia can multiply more easily. The Clostridia multiply so much that a disease develops. The bacteria produce a toxin, which then causes an inflammation of the intestines with severe diarrhoea. Other causes of an outbreak of disease are immunosuppression, old age, chemotherapy or radiotherapy, pre-existing chronic inflammation of the bowel and diseases of the immune system.
Does Clostridium difficile occur in a healthy intestine?
Clostridium difficile can also colonize a healthy intestine without direct disease outbreak. Approximately five percent of all people carry the bacterium inside themselves. Infants in particular are often carriers of Clostridium difficile. Hospital patients are even carriers of the bacterium in 40 percent of cases, as the risk of infection by hospital staff is significantly increased and spores have also been found in the air in intensive care units. Detection of Clostridium difficile in faeces therefore does not necessarily have a disease value.
Diagnosis
Since Clostridia also occur in a healthy intestine, a stool sample with the detection of Clostridia is not suitable for diagnosis. A Clostridia diagnosis is often a clinical diagnosis. The combination of long-term antibiotic administration, severe bloody foul-smelling diarrhoea, abdominal pain and fever together with the stool test result in the diagnosis of Clostridia-induced diarrhoea. In the laboratory, leukocytosis, i.e. an increase in the number of white blood cells, is often still noticeable.
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