A distinctive condition
One of the first things I learned in nursing school was how to spot the distinctive condition that is Clostridium difficile bacterial infection (C. diff). Learning how to recognize C. diff involves identifying its uniquely powerful smell.
If you’re dealing with C. diff during your pregnancy, or you’re concerned about your risk, here’s what you need to know.
One of the most common reasons a person acquires C. diff is, surprisingly, a hospital stay.
C. diff is a bacterium that’s often found in hospitals because it’s a “super bacteria.” It thrives in the overly sterile environment of hospitals. Without a lot of the “lesser” bacteria, or even good types of bacteria, to inhibit its growth, C. diff can have full room to flourish and grow.
The overuse of antibiotics in hospitals can kill off many competing types of bacteria and allow C. diff to take over the hospital environment, or a patient’s body.
People who have surgery and extended hospital stays are at risk for C. diff. But the bacteria are more frequently found in “community settings” outside of the hospital.
This could be because more people get C. diff in the hospital and then go out into the community, or because of increased antibiotic use in the public.
Some strains of C. diff have been found in both healthy babies and adults. But more commonly, the bacteria cause severe diarrhea, colitis, or both.
Pregnant women run the risk of being exposed to C. diff during their hospital stay.
There’s a greater risk with a cesarean delivery than a vaginal one. That’s because a cesarean delivery includes the surgery itself, a longer hospital stay, and treatment with prophylactic antibiotics. These antibiotics are given preventively to ward off infection. (Oh, the irony!)
Burkey developed the condition after she delivered her daughter by cesarean. Her daughter was fine, but after being discharged from the hospital, Burkey wasn’t.
“We came home from the hospital on Thursday,” Burkey wrote. “On Monday I awoke with a fever, diarrhea, and a profound sense of dread. I remember thinking that I was going to die. I felt like I had the flu, but different. I was experiencing a shocking amount of very watery diarrhea. I didn’t even notice the smell at first.”
Burkey expressed frustration that more patients aren’t informed of their risk of developing C. diff after their hospital stays, and about the lack of treatment available.
The current recommended treatment is — you guessed it — more antibiotics. We now know more about the importance of good bacteria in keeping us healthy, so her frustration is understandable.
Is it safe to visit with a friend who has C. diff? Can exposure to a person with C. diff harm my unborn baby (or me)?
C. diff infections are spread by the fecal-oral route, meaning that a person may become infected after ingesting C. diff spores. This generally does not lead to infection in a person whose immune system is not compromised. However, in people who have recently had a course of antibiotics or whose immune system is compromised, the bacteria can grow, eventually becoming an infection.
Take extra care if you choose to visit someone who you know has a C. diff infection. Make sure to wash your hands frequently, especially prior to eating anything. Also, if possible, use a different bathroom than the person infected to avoid coming into contact with contaminated surfaces. Talk with your doctor if you have any concerns of exposure during your pregnancy, especially if you develop diarrhea or abdominal pain.Holly Ernst, PA-CAnswers represent the opinions of our medical experts. All content is strictly informational and should not be considered medical advice.
You won’t automatically get C. diff if you give birth in a hospital, of course. But recognizing the symptoms after you return home can help your doctor make a quick diagnosis.
During your pregnancy, also be cautious about using antibiotics unless absolutely necessary. Be sure to have an open and honest conversation with your doctor. Overuse can put you at an increased risk for C. diff.
If you do develop C. diff during pregnancy or in the postpartum period, treatment options will depend on the severity of your condition. But treatment will likely include rehydration, electrolyte replacement, and antibiotics.
Currently, doctors don’t have enough evidence to recommend probiotics, either as treatment for C. diff or as a preventative measure. But more research is being done and these recommendations might change in the future.
Chaunie Brusie, BSN, is a registered nurse with experience in labor and delivery, critical care, and long-term care nursing. She lives in Michigan with her husband and four young children, and is the author of the book “Tiny Blue Lines.”