Increasing incidence of clostridium difficile infection (c. Diff) challenges common beliefs about its origins

"We have seen C.difficile infection as a cause for diarrhea in humans for more than 30 years, and the incidence of infections has been increasing in the last decade," says Sahil Khanna, M.B.B.S., Mayo Clinic Division of Gastroenterology and Hepatology, and lead author of the study. "It has been believed that the typical profile of a person with C. difficile is an older patient, taking antibiotics, while in the hospital. For the first time, we have described a significantly increased incidence of C. difficile in children with diarrhea in a population-based cohort. Importantly, we also found that more than three-quarters of cases of C. difficile in children are being contracted in the community, not in the hospital."

Results of the study showed that the incidence of C.difficile infection (CDI) in children was more than 12 times higher between 2004 and 2009, compared to the period 1991-1997 (32.6 cases per 100,000 vs. 2.6). In addition, 75 percent of cases were "community-acquired," meaning that the patients had not been hospitalized for at least four weeks prior to contracting C. difficile.

C. difficile is an environmental infection, commonly seen on surfaces in the hospital and described to be present in some food sources, including ground beef. Because the infection can be spread from person to person, Mayo Clinic researchers recommend practicing prevention, including:

• Wash hands with soap and water.
• Clean suspected contaminated surfaces with bleach-based solutions.
• Avoid contact with people who are known to have CDI.
• Take extra hygiene precautions if you are living with a person who has CDI or who works in a health care setting where a person might be exposed to patients with CDI.

About Clostridium difficile C. difficile is a bacterium that is common in the environment. According to the Center for Disease Control and Prevention, approximately 337,000 cases of CDI are reported each year, causing 14,000 deaths. Common symptoms of a mild infection include watery diarrhea two or more times a day for two or more days, and mild abdominal cramping and tenderness. In severe cases, CDI can lead to inflammation of the colon, resulting in fever, blood or pus in the stool, nausea, dehydration, loss of appetite, and significant weight loss.

Other authors of the study include Larry Baddour, M.D.; W. Charles Huskins, M.D., Ph.D.; Patricia Kammer, M.D.; Alan Zinsmeister, Ph.D.; W. Scott Harmsen, M.D.; and Darrell Pardi M.D.