Clostridioides difficile, often called C. diff, is a bacterium that causes severe diarrhea and inflammation of the colon, known as colitis. It is a common healthcare-associated infection, with symptoms ranging from mild diarrhea to life-threatening complications. Understanding how C. diff spreads is important for preventing its transmission and protecting public health.
Is C. difficile Airborne?
C. difficile is not considered an airborne pathogen in the same way that viruses like influenza or the bacteria causing tuberculosis are. Unlike these agents, which can remain suspended in the air for extended periods, C. diff spores are relatively large and heavy. This causes them to settle out of the air quickly, meaning they do not typically remain suspended or travel far through air currents alone.
While air currents can move C. diff spores short distances, such as when bedding is disturbed or doors are opened, this is not its primary mode of transmission. Studies have shown sporadic detection of C. diff in the air around symptomatic patients, but this aerial dissemination primarily contaminates nearby surfaces rather than leading to widespread airborne transmission. Therefore, while airborne presence can occur, it is not the main way the infection spreads.
How C. difficile Spreads
C. difficile primarily spreads through the fecal-oral route, meaning spores shed in the feces of an infected person are ingested. The bacteria form highly resistant spores that can survive on surfaces for months or even years, making environmental contamination a significant factor in transmission. These spores are hardy and resist many common disinfectants.
Contaminated surfaces play a central role in spreading C. diff. Spores can be found on toilets, bed rails, doorknobs, medical equipment, and other high-touch surfaces in healthcare settings. Healthcare workers’ hands can become contaminated after caring for infected patients, and if proper hand hygiene is not followed, spores can be transferred to other patients or surfaces. Patients can also contaminate their own hands and the environment, leading to further spread.
Preventing C. difficile Transmission
Preventing the spread of C. difficile involves several key strategies, with hand hygiene being essential. For C. diff spores, washing hands thoroughly with soap and water is superior to alcohol-based hand sanitizers, as alcohol does not effectively kill the spores. Soap and water physically remove the spores. This method should be used after caring for C. diff patients, after using the bathroom, and before eating.
Thorough environmental cleaning with appropriate disinfectants is also important. C. diff spores are resistant to many standard cleaning agents, so sporicidal disinfectants, such as bleach-based products, are recommended for cleaning contaminated surfaces in healthcare settings and homes. Regular cleaning of high-touch surfaces helps reduce the environmental reservoir of spores. In healthcare facilities, isolation precautions, including private rooms, gowns, and gloves, help contain the spread.
Responsible antibiotic use serves as a long-term prevention strategy. Antibiotics can disrupt the natural balance of gut bacteria, creating an environment where C. diff can thrive. Prescribing antibiotics only when necessary and for the appropriate duration reduces the risk of C. diff infection. This approach helps preserve healthy gut flora, which provides a natural defense against C. diff.