Abdominal pain and diarrhea had taken over Mary’s* life. Every few hours, she had to rush to the restroom, a pattern that eventually led to her losing her job. Worst of all, she couldn’t spend time with her grandchildren because she feared they’d also get sick. When she went to her appointment to see Teena Chopra, M.D., MPH, an infectious disease specialist and professor of medicine at Wayne State University in Detroit, tests revealed the cause of her condition was a bacterial infection called Clostridioides difficile or C. diff. The infection caused her to develop colitis, an inflammation of the colon, which triggered the diarrhea and abdominal pain.“C. diff [infection] has been around for years, but it’s increased in prevalence because we’re using a lot of antibiotics and because more people are being exposed to the hospital environment,” Chopra said. “As we get older, we’re also more susceptible because our immunity is down. It’s a nuisance disease because it causes diarrhea and affects people’s quality of life.”C. diff is the most common healthcare associated infection in the U.S., with nearly half a million cases and as many as 30,000 deaths reported each year. What worries healthcare providers (HCPs) and researchers now is the rise in recurring infections, putting C. diff in the category of infections considered urgent public health threats by the Centers for Disease Control and Prevention. How C. diff infections happenOur bodies have trillions of bacteria, and the majority of our bacteria in our gut make up what’s called the gut microbiome. Our organ systems depend on a balanced microbiome to keep us healthy. When bad bacteria like C. diff overtake healthy bacteria, dysbiosis, a technical term for an imbalance in the gut microbiome, can occur. A healthy microbiome can prevent C. diff from multiplying in the gut, but if there’s an imbalance, C. diff bacteria can grow. That leads to the production of toxins that cause an inflammatory response in the colon, and can trigger debilitating symptoms, such as diarrhea, fever, stomach tenderness or pain, loss of appetite and nausea. C. diff bacteria can be all around us, but an infection most often happens when people are taking antibiotics. Antibiotics kill the bad bacteria in your gut, but they can also kill the good bacteria that help prevent infections. People can also get a C. diff infection from surfaces or objects that contain C. diff spores, which can last on surfaces for a long period of time. Autoimmune diseases, HIV and cancer are among the conditions that can disturb the gut microbiome, but so can treatments like chemotherapy and steroids. Simply being in the hospital, a clinic environment or long-term care facility can put you at risk for a C. diff infection. Many people who spend significant amounts of time in healthcare settings already have weakened immune systems, making them more at risk for infection. Even those who work as HCPs could face a greater risk for C. diff infection due to increased exposure.The unique C. diff