Pregnant and Postpartum Women at Small Risk of Developing C-Difficile
October 15, 2006 by kate baggott
Filed under Health
C-Difficile, or Clostridium Difficile, is a rare but insidious infection of the colon. The bacterium, in small amounts is usually not harmful, but it can become serious if it grows unchecked in the gut after the normal balance of natural bacteria is thrown out of balance. It usually happens after antibiotic treatment and it has also been suggested that use of some antacid treatments, Proton Pump Inhibitors like Nexium, may encourage conditions that allow the C-Difficile bacterium to colonize the colon.
Normally, older people in long term care facilities or hospitals are most at risk for this form of colitis, but it has recently been seen in another group of patients: pregnant women and those who have recently given birth says a study delivered at the annual meeting of the Infectious Diseases Society of America last week.
According to a report of the research in the Globe and Mail, outbreaks of the disease are seldom seen but it is something gynecologists and obstetricians need to be aware of.
- “I don’t want to raise an alarm about this because it’s still obviously relatively uncommon,” lead author Dr. Judith O’Donnell said in an interview with the newspaper.
- “(But) the fact that we had three in a very short period of time and there have been outbreaks in other parts of the country that have identified pregnant women within those . . . is something that I think ob-gyn doctors in particular need to be aware of.”
- “Because it’s not been a disease that they’ve ever really seen very often in any of their patients, let alone in pregnant women.”
Symtoms of the disease usually, but may not always include diarrhea. Abdominal pain after antibiotic treatment (or, possibly, exposure to PPI antacids) and recent hospitalisation or medical treatment that may have resulted in fecal-oral infection should be investigated.
According to both the Globe article and Wikipedia, C-Difficile must be treated immediately after diagnosis has been confirmed and treated aggressively to prevent perforation of the bowel.
With past common strains of CDiff your post is right on target. However, the new epidemic strain is an entirely different ‘animal’ and everyone, of every age, is susceptible. Cases are increasing at an extremely rapid rate in the U.S. (Only about 3% of the population have the bacteria ‘naturally’, not everyone.)
Being an otherwise healthy 43 year old I acquired the new resistant strain and became deathly ill in July, 4 days after a hysterectomy. I was placed in the maternity ward following this surgery. Three months and 3 relapses later, I am still fighting the disease. The new strain is more virulent, causes more severe illness and pain and is very difficult to combat.
Rather than trying ease peoples fears, it would be more beneficial to make them aware of the disease, how to prevent acquiring it and stress no antibiotics unless in dire need. Encourage your readers to require their nurses, and anyone entering their room, to thoroughly wash their hands before doing ANYthing inside their room.
Sheila – a victim in Virginia
Thanks Sheila. Stories like yours make the “mystery bugs” real, rather than just news reports.
Sheila- One more thought: hysterectomy and pregnancy have two things in common exposure to examination by speculum, one of the only tools that is sterilized and reused. And, an examination of an area very close to the rectum and exposed to fecal germs.
Perhaps sterilization methods aren’t as good as they should be?
I had a vaginal birth 2 months ago and acquired c-diff shortly after. I was on antibiotics prior to delivery and finished them while still in the hospital. After I came home, I spend two days with severe watery diarrhea, fever, fatigue and could not eat. I was admitted into hospital for 4 days. They thought I had a uterin infection and treated me with an i.v. drip of more antibiotics. When I was finally able to go home, they put me on another course of antibiotics. I still wasnt feeling 100% though. And then 3 days later I was back in the e.r. after having d 15x in one day, along with a fever. They did a stool culture and determined from my sypmtoms that I had c-diff. I am now on my 3rd round of flagyl and am still fighting it. I would not wish this on my worst enemy. This is an awful thing to deal with. I have not been able to breastfeed due to the flagyl.