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Three weeks away for C. diff?
March 26, 2014 8:01 PM   Subscribe

YANMD, but MD says that positive for C. difficile means staying isolated for at least three weeks. Is this the usual precaution?

I am a relatively healthy 30-odd-year-old person, but somehow a mild case of C. diff happened. So I'm on the antibiotics and (hopefully) the road to recovery. However, my GP says that I'm to stay away from the office and other gatherings until tests come up negative, which takes at least three weeks assuming no difficulties. That's sensible enough—C. diff is extremely contagious. Nevertheless, the murky depths of the web turn up some sources suggesting that once you're asymptomatic, there is not as strong a requirement for such strict quarantine.

Please know that I have absolutely no interest in cutting corners and putting my co-workers at risk. I appreciate that some of them could have conditions that make them sensitive to C. diff infection, although I have no reason to suspect my workplace is different from any other. I am hoping for insight into the current standard of care, which I will then discuss with my doctor before taking any further action.
posted by anonymous to Health & Fitness (11 answers total)
 
My son got c. diff as an infant (9 yrs. ago) and there was no mention of keeping him away from others. However, I guess quarantine is a thing now with it. Here's a link to another AskMe a few years back that might have some relevant info.
posted by Sassyfras at 8:14 PM on March 26


Ask your doctor about fecal transplants. Sounds gross, but it works and reduces reoccurrence rates.
posted by Blazecock Pileon at 8:16 PM on March 26 [2 favorites]


C. diff spores can survive a very long time in the enviroment ( five months according to the first source I looked at), and it's possible that you could still be shedding bacteria even if you're asymptomatic, so I guess your doctor is just being cautious.

This means the spores are going to be present in your house for a while, so you may want to keep that in mind if you have visitors.
posted by Shal at 9:18 PM on March 26


My mom had a case of C. diff a few weeks ago, and she landed in an isolation room in the hospital (gowns, gloves, no masks) for maybe four days. She was way better by the end of the first day, but they wanted to make sure it was completely taken care of. When she went home, my dad was sick (bad cold) and was at a low immunity point, but they were okay. She was back to teaching piano lessons the next Monday.
posted by Madamina at 9:31 PM on March 26


i was suspected of having c-diff and was treated for it for weeks, and although they took certain precautions at the the doc's office, they didn't advise me to isolate.
posted by angrycat at 3:32 AM on March 27


Please talk to your doctor about why he or she makes this recommendation. The particulars of your individual infection or the public health situation in your area may have bearing on this in ways that are not now apparent to you now and that general or anecdotal advice from the Internet cannot address.

C diff is no laughing matter and while quarantine totally sucks for you, if the consequences for others may be far more dire because you don't adhere to it, please have the patience and consideration to follow your doctor's advice.
posted by Sublimity at 5:33 AM on March 27 [7 favorites]


My mother got C. diff a few years ago and they kept her in the hospital for a week or so. She was treated, started feeling better, and they released her. She was feeling a lot better and resumed her normal activities. All was well, or so we thought.

Within a few weeks of her release, the symptoms started creeping back in and returned full force. Apparently the first round of antibiotics didn't quite work so she ended up in hospital for another week a second time. Both times she was in the hospital, we had to wear gowns and masks when we visited. She was given a private room because they did not want to risk her passing it along to other patients (especially those with compromised immune systems).

I posted an AskMe about it and got some great advice. Blazecock Pileon is absolutely right about the fecal transplants. Unfortunately our local health authority sees that as a last attempt, not a primary option for treatment, so Mom's immune system and gut flora were destroyed by antibiotics by the time she was on the road to recovery.
posted by futureisunwritten at 5:54 AM on March 27


I had a terrible case of c. diff. last August, and I was told to simply bleach-solution everything I touched in the bathroom, as well as the area around the toilet, every time I used it. I didn't use the toilets at work during this time.
posted by hanoixan at 8:11 AM on March 27


I had a nasty c. diff. infection several years back that landed me in the hospital for ten days and just barely responded to lots of IV flagyl. I was in a private room and the staff who cared for me were taking extra precautions, but I was released without any quarantine-type provisions.

Just a datapoint.
posted by werkzeuger at 8:25 AM on March 27


Another vote for a fecal transplant. They're a little squicky from the point of view that sterilizing the fecal donation would miss the point but the other parts can be controlled and the transplant can be administered by a doctor and the donor can be screened for complicating and undesirable factors.
posted by kalessin at 12:27 PM on March 27


So, the reason c.diff has "difficile" right in the name is that it is fucking DIFFICULT. The spores hang around forever and aren't killed by alcohol-based sanitizers. C.diff is resistant to a lot of antibiotics so if you take antibiotics that kill all your other gut flora you are basically clearing the decks for the c.diff to take root - just like if you killed all the grass on your lawn, weeds would grow like mad.

I work in a hospital so there is a nonzero chance I'm colonized with c.diff, meaning the bacteria are there but I don't have symptoms. You could pass c.diff on to someone else, who may not ever show symptoms -- but if they later took a course of antibiotics that wiped out their good gut flora but not the c.diff, then suddenly the c.diff can proliferate like crazy. This is what your doctor wants to avoid.

That said, I don't think there is a standard of care that requires you to be isolated in the community. If you were in the hospital, you absolutely would have to be in isolation, meaning the doctors and nurses garb up in disposable gowns & gloves when they go into your room and then toss them to prevent infecting other patients. I don't know of official recommendations one way or the other for outpatient -- I suspect that if you went to different doctors you'd get varying answers. I'm no expert though, and maybe one of our doctors will weigh in.
posted by selfmedicating at 9:47 PM on March 27


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