What can you tell me about C. diff, thank you!

JMB0514 · Sep 19, 2014

CDC - C. difficile information for clinicans - HAI

Here is a link to page from the CDC. You might find the FAQ section helpful. One big thing to remember with C. diff is hand washing. The alcohol hand sanitizer is not enough.

NurseGirl525, ASN, RN · Sep 19, 2014

CDiff is clostridium difficile. It actually occurs mainly in restrooms because it in feces. When people touch the handles of the faucets to wash their hands or don't wash at all it gets everywhere. Most healthy people don't have a problem with it but those who are immunocompromised are the ones who have a problem with it. My mom gets it any time she goes on an antibiotic because they wipe out her immune system so bad. It cause horrible stomach cramping. You are wearing PPE to protect mainly your other residents. As you age especially the immune system goes down so they are at risk of contracting it. CDiff can be deadly if not treated. You wouldn't want to get feces on your scrubs and then transfer it to another person's room. That is why you are wearing it. But also to protect yourself. You wouldn't want to get it either. My mom rarely uses public restrooms anymore. At work, she has to pretty much disinfect everything in the restroom before she uses it. Her doc will only prescribe antibiotics in extreme cases. She has had it 3 times and almost died the one time. Plus it is a horrible smell as I am sure you already know.

mrsboots87 · Sep 19, 2014

In a nutshell, C.diff is naturally occurring in your body in small amounts and kept in check by the other microflora in your intestines. Anyone can "contract" it, but generally healthy people don't. The most common way to get it is by being on long term use antibiotics or by taking antibiotics often. The broad spectrum antibiotics can wipe out the healthy bacteria in your body (hence why it is also relatively common for females to get a yeast infection when using antibiotics). C. diff is resistant to most types of antibiotics except the big boys that make you feel terrible (was your resident taking vancomycin (sp?)). So the broad spectrum antibiotics being used to treat whatever other infection they had will not kill the c.dif. When the other bacteria in the gut are no longer there to keep C. diff in check, then it starts to grow. As it does, it can form spots in your colon where nutrients cant be absorbed. When not treated those spots grow. The colon is responsible for removing most water as well as many nutrients and fat from feces before you excrete it. When it is unable to do that, you get watery diarrhea and you become malnourished. Eventually, if it is not gotten under control, you can die.

Basically the reason you where the protective gear is because C. diff has endospores protecting their vital components. So it can survive outside the body for a short period of time and is very antibiotic resistant. If you come in contact with a contaminated object (linens, the patient, the feces itself), that bacteria will survive on your hands, scrubs, shoes, whatever. Your scrubs ore mostly protected by the equipment and your hands by the gloves. You wear a facemask for the just in case some freak accident happens and you get it in your face or mouth (yuck but it has happened before). The when you are done, hand sanitizer will not kill C. diff endospores so you HAVE to wash your hands and forearms or it will continue to cruise on your skin (if contaminated on accident). Then that's where it gets passes around the unit if not properly cleaned off of you, or if on your scrubs (if you were to not where a gown). In the elderly or immunocompromised, they have a higher risk of contracting illness if you pass it to them. For yourself, if you were to say wipe your rear or ingest contaminated food or water, then you can get it too. If there is more C. diff in the body then supposed to be, then it can essentially wipe out the good bacteria in your colon and colonize. This is not super common, so you are mostly protecting your residents, but you also want to definitely protect yourself. One wash cycle should be fine and for shoes, just don't go licking the soles and you should be fine.

ICURN3020 · Sep 19, 2014

It stinks and once you smell it, you'll recognize it every time :barf02:

HelloWish, ADN, BSN · Sep 19, 2014

Ok, thanks for the info y'all! Good thing I started taking my probiotics!!! It is what I thought. I am still a bit worried, which I guess is natural as a beginning nursing student! :-)

nowim clean · Sep 19, 2014

The ppe is to protect you and yes even if you are healthy you can get it. Handwashing gets rid of the spores that will be on your hands gel will do nothing you will eat something .... well you can imagine how it goes.

monkeyhq · Sep 20, 2014

Don't forget to scrub those shoes, too!

I make it a habit--no matter what care environment I may be in--to always take off my shoes in the parking garage/lot and bag them before getting into my car. I don't want hitch hikers tracked through my house on my hardwood floors and carpet. I have a shallow bin in my garage where I place my shoes, and I use a solution (1 teaspoon of bleach to one pint of water) to wipe down the uppers, and dip the soles (so the solution gets into the tread). Clorox wipes are pretty effective for everyday use to wipe down shoes, but if C-diff is known in a facility, I would be sure to dip the soles. I also rotate shoes every other day.

I only buy scrubs that I can wash in hot water and dry on high heat. And I use a scoop of Oxyclean in addition to a good detergent.

Maybe I am a bit neurotic, but I don't want my family and friends to hang out in my house and catch a nasty. :snurse:

HelloWish, ADN, BSN · Sep 20, 2014

I bought some clorox wipes for healthcare to wipe my shoes with yesterday. Unfortunately, my scrubs cannot be dried on hot! I did wash them on a sanitary cycle 3 times however. I hope that is enough. I took my shoes off before entering the house and placed them in a special bin where I will keep my nursing shoes...it just seems so impossible to prevent the spread of pathogens!

We all started taking probiotics with strains that are suppose to inhibit antibiotic associated diarrhea. So, I hope that keeps our guts in good health! None of us use antibiotics or have ever had a need to, thankfully!

mariebailey, MSN, RN · Sep 20, 2014

You should really visit the CDC's website for more information. Not all the info posted is accurate. There is no need to take probiotics after caring for a patient with CDiff, especially if you followed contact precautions & had appropriate hand hygiene. Ask people at the facility a/b environmental cleaning; if they are doing it right, they clean the patient's room with bleach routinely, which does kill the spores. As a nursing student, you need to know the importance of using contact precautions, hand hygiene, & bleach to prevent the transmission to other patients in the facility. You also need to know when to suspect & report it to arrange for testing.

Although the exact incubation time for CDI is unknown, the time from acquisition to disease is relatively short, perhaps no longer than 7 days.

By the way, if you aren't sick within a week, you probably won't be. Clostridium difficile

HelloWish, ADN, BSN · Sep 20, 2014

Thanks for the article. I cannot speak about the facility in any way!

Thank you, I am aware of following the contact precautions which I did. I am taking probiotics long term as a means of protecting myself and my family in general, I just didn't get serious about it until after working with a C. diff patient! It will not hurt us and can only help esp. if or when we may need to take antibiotics.

I read the CDCs website too, but didn't get the info I was hoping to find out other than basic facts. I really want to understand the disease process and how and why it happens. I just don't know where to go to find factual information!

I read an article which contained metaanalysis and RCTs regarding certain strains of probiotics which help to inhibit growth of antibiotic associated diarrhea and C. diff and I wonder why this isn't used more in practice with patients who actually contract C. difficile or to prevent it. This is the same concept behind using a fecal transplant, and it seems that C. difficile could be reduced by the very simple means of using probiotic therapy with the elderly, esp. during abx treatment.

rob4546, ADN, BSN, MSN · Sep 20, 2014

Don't forget to scrub those shoes, too!
I make it a habit--no matter what care environment I may be in--to always take off my shoes in the parking garage/lot and bag them before getting into my car. I don't want hitch hikers tracked through my house on my hardwood floors and carpet. I have a shallow bin in my garage where I place my shoes, and I use a solution (1 teaspoon of bleach to one pint of water) to wipe down the uppers, and dip the soles (so the solution gets into the tread). Clorox wipes are pretty effective for everyday use to wipe down shoes, but if C-diff is known in a facility, I would be sure to dip the soles. I also rotate shoes every other day.
I only buy scrubs that I can wash in hot water and dry on high heat. And I use a scoop of Oxyclean in addition to a good detergent.
Maybe I am a bit neurotic, but I don't want my family and friends to hang out in my house and catch a nasty.

I don't think that this is neurotic at all. I regularly scrub shoes in the garage and do not wear them in the house at all. In fact I do not wear scrubs that I wore throughout the day in the house. I pull scrubs off in the garage before coming in the house. Scrubs are washed separately from the families clothes.

If this is neurotic, then sign me up!