How C. difficile spreads
C. difficile is transmitted from person to person by the fecal-oral route. The organism forms large numbers of heat-resistant spores. These are not killed by alcohol-based hand cleansers or routine cleaning of surfaces. These spores remain viable in the hospital or nursing home environment for long periods of time. Because of this, the bacteria can be cultured from almost any surface in the hospital. Once spores are ingested by a patient, they pass through the stomach unscathed because of their acid-resistance. They germinate into vegetative cells in the colon upon exposure to bile acids, and multiply.
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