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healthcare-associated infections (HAI) program 

Clostridioides difficile Infection (CDI)

Clostridioides difficile Infection (CDI)


Clostridioides difficile (also known as C. difficile or "C. diff" ) is a germ that can cause diarrhea. Most cases of C. diff infection (CDI) occur when the C. diff germ is ingested by a person who has taken antibiotics. Symptoms can be mild and last only for a short time, or can be more serious and come back many times.


What are the symptoms of CDI?

  • Watery diarrhea
  • Abdominal (belly) pain/tenderness
  • Fever
  • Nausea
  • Loss of appetite

Who is most likely to get CDI?​

  • Anyone who takes an antibiotic is at risk of infection.
  • The elderly and people with certain medical problems are at high risk of infection.

How do you get CDI?

For C. diff  to cause infection in the gut, the following events must occur:

  • The C. diff  germ must be ingested, and
  • The normal gut bacteria must be disrupted by antibiotic use.

These events may occur at different times and in any order. 

How does C. diff  spread?

The C. diff  germ can live outside the human body for a long time and may be spread in healthcare settings by contact with items in the environment such as medical equipment. The germs can spread from person to person on the hands of healthcare providers.

What are healthcare facilities doing to prevent CDI?

To prevent CDI, doctors, nurses and other healthcare providers must:

  • Only give patients antibiotics when needed.
  • Clean their hands before and after caring for a patient.
  • Put on gloves and wear a gown over their clothing while taking care of patients with CDI.
  • Carefully clean and disinfect hospital rooms and medical equipment.
  • Whenever possible, place patients with CDI in a single room or in a shared room only with someone else who has CDI.

What CDI information is reported to the California Department of Public Health (CDPH) and where can I find that information?

  • All California general acute care hospitals are required to report CDI cases that occur during a hospital stay. CDPH calculates the rates of infection at each hospital and makes that information available to the public (Health and Safety Code Section 1288.55). 
  • Find hospital infection rates using the HAI Program's Interactive Map.

What can patients do to prevent CDI infections?

  • Ask your provider to clean their hands before and after caring for you.
    If you do not see your healthcare provider clean their hands, please ask them to do so.
  • Ask your healthcare provider if any medical equipment was cleaned and disinfected before it was brought into your room.
  • Clean your hands often, especially after using the bathroom and before eating.
  • Know when antibiotics work. Only take antibiotics when prescribed by your doctor. See the CDC Be Antibiotics Aware website for more information.

Additional CDI Resources

  • World Health Organization How to Hand Wash (PDF)
    Infographic on how to wash hands.

HAI Program

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