C. Diff: Can You Get Infected at Your Doctor’s Office?

C. Diff is a nasty, drug-resistant bacteria once mainly found in hospitals -- but recent cases have been tied to doctor’s and dentist’s offices.

Medically reviewed in July 2021

A recent study from the Centers for Disease Control and Prevention (CDC) revealed that Clostridium difficile, or C. diff—once mainly found in hospitals and long-term healthcare facilities—may be lurking at your doctor’s or dentist’s office.

The CDC study, published in The New England Journal of Medicine, reported that in 2011 some 450,000 people were infected by C. diff—a potentially deadly bacteria. Approximately 29,000 deaths occurred in the first 30 days after diagnosis, with half directly related to infection by this superbug. Health officials say that two-thirds of those cases occurred in hospital or nursing home settings—but that means one-third of the cases occurred in communities, giving rise to concerns about how far and wide it has spread.

A related CDC study found that 150,000 people who were diagnosed with C. diff in 2011 had not been to a hospital—but 82 percent had visited a doctor's or a dentist's office within 12 weeks before their diagnosis. Officials aren’t certain if those patients already had C. diff when they arrived for treatment.

C. Diff is yet another on the list of drug-resistant bacteria, such as MRSA, that has migrated from hospitals to the general community.

What is C. diff?
C. diff is a bacteria that is found in feces and lives in the intestines of a small number of people. If you become infected with C. diff, it’s usually harmless, being kept in check by other, “good” intestinal bacteria. Ironically, one of the main causes of C. diff infection is the use of antibiotics. Antibiotics not only kill off the germs that make you sick, they’re strong enough to kill some of the normal intestinal bacteria that keep C. diff under control. When that battle is lost, C. diff produces toxins that damage the lining of the colon, causing a range of medical problems, from inflammation to deadly diarrhea.

What are the symptoms?
Symptoms range from mild to severe. Signs include:

  • Watery diarrhea several times a day
  • Loss of appetite
  • Abdominal pain or tenderness
  • Nausea
  • Dehydration 

A more severe reaction may also include a low-grade fever, high white blood cell count and blood or pus in the stool.

Who is at risk?
Those most vulnerable to C. diff are the elderly (65 and older) who have been hospitalized and taking antibiotics, as well as people with medical conditions requiring them to take antibiotics over a long period of time. There are additional concerns about the rise of C. diff in children.

How does C. diff spread?
The bacteria reside—and are shed—in the feces of people who are infected. In hospital settings toilets, bathroom fixtures, bed linens and medical equipment are common hot spots for C. diff spores. Making matters worse, the bacteria can live on surfaces for months if not disinfected properly. The hands of hospital workers who have touched surfaces contaminated by C. diff and then administered care to patients often transmit it. Patients can infect themselves by touching a contaminated object or surface, then putting their hand to their mouth or nose, giving C. diff an easy entry point.

How is it treated?
If you’re taking an antibiotic when diagnosed, your doctor may ask you to stop taking it. While it may sound counterintuitive, more serious cases of C. diff are treated with metronidazole or vancomycin, two antibiotics known to be effective in treating C. diff. Symptoms start easing up within 72 hours and are gone after 7 to 10 days. However about 25 percent of people have recurrences, which may require additional rounds of antibiotics. People with severe cases may even need to be admitted to ICU or have emergency surgery.

How can I avoid getting C. diff?
Because the bug is a hardy one, it’s important to practice good hygiene, especially after a visit to a doctor’s office or other healthcare facility. Be sure to:

  • Wash your hands regularly with soap and water; don’t rely on alcohol-based hand sanitizers to do the job.
  • Ensure that surfaces are cleaned with bleach-based products if you think an infected person has touched them—everything from doorknobs to mobile phones and keyboards.
  • Avoid taking antibiotics unless absolutely necessary. If your doctor says you need an antibiotic, ask if there is one that is less potent. Also ask for the shortest possible course of treatment to limit your exposure.

While overuse of antibiotics is a main culprit for growing C. diff antibiotic resistance, experts say more research is needed to know if you can, in fact, catch C. diff in outpatient healthcare facilities like your doctor’s or dentist’s office. In the meantime, be smart about taking antibiotics—they can sometimes do more harm than good.

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