More than nine out of 10 hospital infections with C. diff occur in people who have received antibiotic treatment.
But community-acquired C. diff does not depend on antibiotics. The CDC's C. diff expert, L. Clifford McDonald, MD, says there's evidence that 30% to 40% of community-acquired cases are in people not suffering a current or recent medical problem.
Fluoroquinolone antibiotics are most strongly linked to C. diff disease. Risk is also higher for patients who receive multiple antibiotics and for patients who receive longer courses of antibiotic treatment.
Other risk factors include:
- Age over 65.
- Severe illness.
- Nasogastric intubation.
- Anti-ulcer medications. There is conflicting evidence on this.
- Long hospital stays, particularly in long-term-care facilities.
It's not at all clear how long it takes to get C. diff disease after you've ingested the spores. One study that performed a series of cultures in hospital patients showed that patients who had C. diff disease were not infected the week before.
This suggests incubation can occur in less than seven days. But another study found an increased risk of C. diff disease throughout the first four weeks after leaving the hospital.
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