C. Difficile Infections and Fecal Transplants

C. difficile is a bacterial infection, also known as C. diff, that can potentially lead to deadly complications. According to the Mayo Clinic, Clostridium Difficile infections often occur while taking or after finishing a course of antibiotics and in people who were hospitalized or living in care facilities such as a nursing home. The Virginia Department of Health estimates there are approximately 333,000 new cases of C. diff infections diagnosed each year in the United States, while the CDC shows 94 percent of cases are associated with medical care and about 14,000 deaths yearly in the United States. It is usually diagnosed with a screening test to detect the bacteria in feces. C. diff is transmitted through feces and experts warn most people are infected when either their hands or their care provider’s hands come in contact with the fecal matter (Centers for Disease Control and Prevention, 2012). Good hygiene through hand washing or hand sanitizer is critical. A key concern is the high rate of recurrence in patients diagnosed with C. diff, but a relatively new treatment involving fecal transplants is curing those affected at a high rate.

C. diff infections can vary in their severity. Symptoms of mild C. diff include cramping and pain of the abdomen, as well as watery diarrhea that happens more than three times a day for at least two days (Agency for Healthcare Research and Quality, 2011). Severe C. diff often causes the colon to become inflamed and is also characterized by the same watery diarrhea, but it tends to occur about ten to fifteen times per day. Typically, diarrhea and abdominal cramps are accompanied by fever, vomiting and other symptoms (Surawicz, 2013).

Most often, mild symptoms occurring for the first time can be treated with medication, including antibiotics, but C. diff can recur in those diagnosed. Often, such a recurrence will happen within a week or two and affects about ten to twenty-five percent of patients (Borody et. al, 2014). Once there is a recurrence, it is not uncommon for the patient to experience multiple, difficult-to-treat bouts of C. diff infection. Fecal transplants can be used to combat the infecting bacteria.

A fecal transplant involves taking feces from someone who is healthy and putting it into the GI tract of the patient with C. diff (Bakken, 2009). While it is not the most common method of treating recurring infections, it is perhaps one of the most effective. About 91 percent of patients have been successfully treated with this procedure (Surawicz, 2013). Many doctors believe this course of treatment is well-suited to treating C. diff infections because it brings healthy bacteria to the intestines and allows for the new bacteria to fight the infection and keep it from controlling the body’s ecosystem (Brandt, 2012). Additionally, Brandt notes a fecal transplant carries the same risks typically seen with a colonoscopy and considers them to be minor. The success of fecal transplants in treating recurring C. diff is critical because research shows nearly a ten-percent spike in deaths among patients over a ten-year period in Quebec and other Canadian provinces, as well as the doubling of patients being discharged from hospitals after battling this infection in the United States (Freeman et. al, 2010).

C. diff infections can be treated in most patients, but because they recur frequently, fecal transplants are becoming a more common method to rid sufferers of the infection completely. C. diff is an important topic for me to research because I see it commonly in the nursing home where I work. This makes sense because many of the patients carry most of the risks for C. diff infections: they are living in a nursing home, may be on antibiotics to treat another illness, and tend to be older or elderly. Researchers note that, as of 2012, there are about 450 known cases of using fecal transplants to treat C. diff infections (Brandt, 2012), so there is room for the procedure to make an impact in the lives of more chronic C. diff patients.

Works Cited

Agency for Healthcare Research and Quality. “Treating and Preventing C-diff Infections: A Review of the Research for Adults and Their Caregivers.” 2011. Web. http://effectivehealthcare.ahrq.gov/ehc/products/115/891/cdiff_cons_fin_to_post.pdf

Bakken, JS. “Fecal bacteriotherapy for Clostridium difficile infection.” Anaerobe 15.6 (2009): 285. Web.

Brandt, Lawrence J. “Fecal Transplantation for the Treatment of Clostridium difficile infection.” Gastroenterology & Hepatology 3 (2013): 191-194. Web.

Borody et. al. “Fecal microbiota transplantation in the treatment of recurrent Clostridium difficile infection.” Published and reprinted to UpToDate.

“C. difficile Infection.” Mayo Clinic Staff. <http://www.mayoclinic.org/diseases-conditions/c-difficile/basics/definition/CON-20029664?p=1>

"Clostridium difficile Infection." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 17 May 2012. Web. 4 Feb. 2014. <http://www.cdc.gov/hai/organisms/cdiff/Cdiff-patient.html>.

Freeman et. al. “The Changing Epidemiology of Clostridium difficile infections.” Clinical Microbial Review 23.5 (2010): 529-549.

"Making Health Care Safer." Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 6 Mar. 2012. Web. 5 Feb. 2014. <http://www.cdc.gov/VitalSigns/Hai/Stoppi

Surawicz, Christina. "C. difficile Infection." ACG Patients. Virginia Department of Health. "Clostridium Difficile (C. Difficile) Infections." Clostridium Difficile (C. Difficile) Infections. N.p., n.d. Web. 5 Feb. 2014. <http://www.vdh.virginia.gov/epidemiology