C. Diff (Clostridium Difficile)

C.diff, C.difficile, or simply CDF/cdf are all shortened versions of Clostridium difficile. This is a bacterium belonging to the Clostridium genus (clan). It is anaerobic1 and has two forms:
  • An active and infectious form that cannot survive outside the host (i.e. the body) for extended periods of time. This form produces at least two poisons, Clostridium difficile toxin A and toxin B. Toxin A causes fluid to accumulate in the intestine whilst toxin B results in degenerative changes to cells, leading to their deterioration over time. These toxins work collectively and can cause serious, sometimes life-threatening disease.

  • A non-active form, known as a spore, that is capable of living outside the host for prolonged episodes of time. These spores are very adaptable to a wide range of conditions and can be found on any surface, device or material that has come in contact with feces such as commodes, hands, bathing tubs, furniture etc. The spores do not cause infection directly but once ingested, they can transform into the active and infectious form.

Who Is at Risk from Infection?



In healthy people C. diff or Clostridium difficile does not cause a problem. Indeed, the bacterium is part of the normal digestive flora and is present in the gut of around two-thirds of children and three percent of adults. Infection occurs only when the balance of the digestive flora is disturbed. Risk is highest in 2:

Various Different Groups of People are at Risk from Infection with C. Diff (Clostridium Difficile)

  • Elderly people.

  • People who are taking or have recently received antibiotic therapy.

  • Patients who have a serious underlying health condition.

  • People who have had a previous C. difficile infection.

Infection is most common in health care settings such as hospitals and care homes. Thus those staying in such environments for extended periods are also at increased risk of infection.

However increasingly people who aren’t taking antibiotics or who have not been hospitalized are becoming infected.

Symptoms of Infection

The symptoms of C. diff or Clostridium difficile infection vary widely in severity from person to person. They include:

  • Mild to severe watery diarrhea.

  • Abdominal and back cramps.

  • Blood and/or mucus in stools.

  • Fever.

  • Loss of appetite.

Complications Resulting from Infection

In severe cases, infection with C. diff or Clostridium difficile can cause the following conditions:

  • Pseudomembranous colitis (PMC), also known as antibiotic-associated colitis or clostridium difficile colitis or simply c. difficile colitis.

  • Toxic megacolon

  • Perforations of the colon

  • Kidney failure

  • Sepsis

  • Death

Probiotics for Clostridium Difficile Infection

If you have C. diff or Clostridium difficile infection you will almost certainly have been given antibiotic treatment. Generally the antibiotic drugs of choice are Flagyl (metronidozole) as the first line of attack, and as a last resort, Vancocin (vancomycin) for cases where the Flagyl proves ineffective. This treatment will hopefully clear the infection.

However the infection is becoming increasingly difficult to treat and if you are one of the unlucky 20% of patients, you will find that your infection reoccurs after this standard antibiotic therapy.

Panic not though....

Over recent years scientists have begun to consider the use of probiotics as treatments for C. diff or Clostridium difficile infection. The good news is that there are two specific probiotics which have proven benefit. These are:

  • Saccharomyces boulardii

  • Lactobacillus rhamnosus GG

Specifically Saccharomyces boulardii has been shown to:

  • Reduce the rate of the recurrence of C. diff or Clostridium difficile infection when combined with antibiotic therapy3,4.

  • Decrease the risk of developing antibiotic associated diarrhea5,6.

What’s more Saccharomyces boulardii is a beneficial yeast so its big advantage over probiotic bacteria is that it is not killed by antibiotics. You can therefore take Saccharomyces boulardii with antibiotics.

The other probiotic, which has been proven to be of benefit in treating relapsing Clostridium difficle diarrhea is Lactobacillus rhamnosus GG7,8. Additionally, it is thought that Lactobacillus plantarum may also be of benefit in recurrent Clostridium difficile diarrhea9.

Where Can I Find These Specific Probiotics?

If you want to try these specific species and strains of probiotics for a Clostridium difficile infection, you may be wondering where to source them. In the US, you can find them in the following products:

  • Saccharomyces boulardii: Florastor

  • Lactobacillus rhamnosus GG: Culturelle probiotic products
  • Lactobacillus plantarum: as a stand alone single strain probiotic such as that produced by Custom Probiotics or in a probiotic blend such as that contained in VSL3.

You can buy these probiotics at your local health food or drug store or at internet retailers. Read our buyer's guidelines before you purchase your chosen product to ensure you end up with a potent product.

References

1.This means that Clostridium difficile cannot grow or multiply in the presence of oxygen.

2.CDC.gov

3.McFarland L.V et al; A Randomised Placebo-Controlled Trial of Sacchromyces Boulardii in Combination with Standard Antibiotics for Clostridium Difficile Disease; JAMA; 1994; 271:1913-1918

4.Surawicz, C.M et al; The Search for a Better Treatment for Clostridium Difficile Disease: Use of high Dose Vancomycin Combined with Sacchromyces Boulardii; Clin Infect Dis; 2000; 31: 2012-2017

5.Mehmet, C. et al; Propylactic Sacchromyces Boulardii in the Prevention of Antibiotic Associated Diarrhea: A Prospective Study; Med Sci Monit; 2006; 12:119-122

6.Surawicz, C.M et al, Prevention of Antibiotic Associated Diarrhea by Sacchromyces Boulardii: A Prospective Study; Gastroenterology; 1989; 96: 981:988

7.Gorbach S.L et al; Successful Treatment of Relapsing Clostridium Difficile Colitis with Lactobacillus GG; Lancet; 1987;2:1519

8.Biller J.A et al; Treatment of Recurrent Clostridium Difficile Colitis with Lactobacillus GG; J Pediatr Gastreoenterol Nutr.; 1995; 21:224-226

9.Biller J.A et al; Treatment of Recurrent Clostridium Difficile Colitis with Lactobacillus GG; J Pediatr Gastreoenterol Nutr.; 1995; 21:224-226


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