How does someone get contaminated with Clostridium difficile?

C. difficile can be acquired from a carrier and spread by direct or indirect contact.  E.g. with contaminated surfaces or hands or air-borne spores.

The heat-resistant spores can survive outside the body and remain viable for weeks on surfaces.  E.g. bed rails, blood pressure cuffs, thermometers, tabletops, telephones, stethoscopes etc. The organism can persist in hospital rooms for up to 40 days after infected patients have been discharged. Hurley BW, Nguyen CC. The spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea. Arch Intern Med. 2002;162:2177-84.

Another source says C. Diff can survive 5 months even on a dry surface. Kramer A, et al. BMC Infect Dis 2006;6:130

The many spores formed by C. difficile resist most surface cleaning methods.  There are cleaning solutions that will "get 'em"

Cleaning solutions for C. Diff

The spores are commonly spread from one patient to another.  Via unwashed hands of caregivers or via tubal insertions into the body (E.g. via nasogastric tubes or administration of enemas /enteral feedings).

Antibiotic/Other medication involvement in C. Difficile infections

Broad spectrum antibiotics (E.g. clindamycin, (Cleocin), fluoroquinolones: ciprofloxacin (Cipro) and levofloxacin (Levaquin), cephalosporins: Ceftin, Omnicef, Rocephin, Maxipime) are more strongly associated with C. difficile infections than other antibiotics;

Increasing rates of community-acquired (nosocomial) C. difficile infection are associated with the use of medication that suppress gastric acid production

•  H2-receptor antagonists increased the risk 1.5 fold, and proton pump inhibitors by 1.7 with once daily use and 2.4 with more than once daily use.

•  All anticholinergic drugs (E.g. the PPI Omeprazole) slow digestive transit time, and so retain toxins to exacerbate gut damage.