Analysis of Clostridium Difficile Essay

Clostridium difficile associated disease will resolve when the patient discontinues taking the antibiotics to which he/she has been previously exposed (Nipa, 2010). Administration of a different antibiotic is used to treat the infection (Grossman, 2010). The infection can usually be treated with an appropriate course of about 10 days of antibiotics including metronidazole or vancomycin administered orally (Nipa, 2010). On occasion intravenous vancomycin may be necessary (Gould, 2010). The nurse should ensure patients are not only taking the newly prescribed antibiotic, but also responding to the treatment by showing a decrease in symptoms. Symptoms can recur despite antibiotic therapy, close monitoring is essential. In order to avoid risk of further complications, nursing interventions would include careful assessment of white blood cell count, temperature, and hydration status; meticulous skin care and assistance with bowel elimination given the loose frequent stools; and management of abdominal discomfort (Grossman, 2010).

Clostridium difficile (C. diff) is a type of bacterium that can cause a person to endure diarrhea like symptoms to more drastic symptoms that may involve inflammation of the colon. Most people who come across C. diff are expected to be in a hospital setting for an extensive period of time. It is more accessible to acquire C. diff when a person is of old age, in a hospital setting, and taking antibiotic medication (Mayo Clinic, 2016). Normally, one would think that taking antibiotics would not cause any harm to the body, but would instead help the body fight off diseases. However, once a person who has been taking antibiotics for a long period of time stops taking them, such as in a nursing home or hospital setting, that person can develop some reactions in the absence of those antibiotics (Bartlett, 2012). This reaction, then allows the person to experience diarrhea symptoms, which lead to inflammation of the colon and more drastic colon problems.

Clostridium difficile is a Gram-positive, spore-forming, rod-shaped bacillus that is renowned for being the leading cause of hospital-acquired diarrhea in adult patients. C. difficile is present as normal intestinal flora within 3% to 5% of healthy people2, while its spores are ubiquitous in the environment, especially in hospital settings. It grows at an optimal temperature and pH of 37ºC and 6.5–7.5 respectively.1 It is an obligate anaerobic as it thrives in the absence of oxygen. It is highly motile with the presence of peritrichous flagella, which are evenly spread out along its surface. As briefly mentioned above, this evolving pathogen produces endospores. The bacterium produces dormant spores, which are extremely hardy and resistant to antibiotics, the host’s innate immune system, and once shed into the environment through the host’s feces, they are resistant to unfavorable aerobic conditions3 as well as several types of bleach-free disinfectants, which are commonly used in hospitals.3 The spores will germinate under the favorable conditions of the intestinal tract, resulting in the multiplication of vegetative cells, colonizing in the gastrointestinal tract. The vegetative cells release two powerful exotoxins upon adherence to the epithelial cells of the GI tract. Pathogenic strains of C. difficile produce two exotoxins: toxin A and toxin B. Toxin A is an enterotoxin that causes fluid excretion, resulting in fluid accumulation and watery diarrhea. Toxin B is a potent

Clostridium Difficile (C-Diff) is considered one of the most common infections a patient can acquire within their hospital stay. It is estimated that C-Diff is responsible for 337,000 infections and 14,000 deaths a year (Centers for Disease Control and Prevention, 2012). Working in the emergency department (ED), I have witness first hand how debilitating this gastrointestinal infection can be. Patients are admitted to the ED for having severe watery diarrhea, abdominal pain, and fever. Elderly patients are at increase risk for sepsis and dehydration related to recurrent infections. Appropriate management and education of C-Diff is optimal for patient survival and decrease contamination across lifespan.

Many Americans die each year from complications connected to Clostridium difficile. It can ill a significant number of individuals as well as animals. The Clostridium difficile infection is the result of poor hygiene, misuse, overuse of antibiotics and an aging population. In this paper I will be discussing the following topics, what clostridium difficile means, what it causes, signs and symptoms, complications, treatment and the prevention.

Clostridium difficile is a gram-positive, spore-forming, anaerobic bacillus. Since the turn of the 21st century, there has been a dramatic increase in the number of nosocomial infections associated with antibiotic exposure and an increase in the severity of the disease. Challenges of disease containment include emerging risk factors and recurrence. In 2008 the acute care costs, not including the economic burden placed outside of the hospital, was estimated to be around $4.8 billion in the US. As such, it has become clear that preventative measures are needed to monitor and reduce the risk of infection and recurrence.

The healthcare professional can expect to encounter various conditions within their scope of experience. Clostridium difficile represents one of the most common and challenging nosocomial infections that can cause life-threatening complications such as hypervolemia, sepsis, pain, and peritonitis (Grossman and Mager 155). The recognition, diagnosis, treatment and inhibition of transmission of this bacterium are imperative in order to limit infection and prevent death.

Clostridium difficile, or C. difficile for short, are words that every healthcare worker hates to hear that their patient has, or may potentially have. This spore forming bacterium has significant healthcare-associated infection potential. An especially virulent strain has affected health care facilities throughout the U.S. and North America in the past few years. What C. difficile is, its symptoms, how it is transmitted, and the prevention transmission are important issues to all healthcare workers. These questions and issues will be covered in this paper.

difficile happen in patients who are taking sure anti-toxins in high measurements or over a drawn out stretch of time. A few anti-microbials can pulverize a man's ordinary microorganisms found in the gut, bringing on C. difficile microscopic organisms to develop. At the point when this happens, the C. difficile microbes produce poisons, which can harm the entrail and reason looseness of the bowels. On the other hand, a few individuals can have C. difficile microscopic organisms present in their entrail and not demonstrate indications.

Clostridium difficile is a gram positive, anaerobic, spore forming bacillus. In 1935 it was first described as member of the intestinal flora in healthy neonates [1] , and then in 1978 it was recognised as a cause of diarrhoea [2]. Today it is widely acknowledged as the leading cause of hospital-acquired diarrhoea. This organism can cause a variety of diseases, from mild diarrhoea to severe pseudomembranous colitis, and collectively these are known as C. difficile infections (CDIs) [3]. It is known that the symptoms seen in patients infected with C. difficile are due to the toxins (toxin A and toxin B) that are produced by the organism [4]. Some strains of C. difficile seem to have an increased virulence which can be associated with increased severity, recurrence and increased mortality. This increased virulence is thought to be a result of increased expression of toxins A, B [5]. There is also another toxin produced by C. difficile known as binary toxin, this is also thought to contribute towards increased virulence [6]. A particular strain of C. difficile that does seem to have increased virulence is the strain known as PCR ribotype O27 or North American pulsed (NAP)-field type 01. In Europe PCR ribotype O27 is the sixth most common ribotype [7], and new ribotypes are being detected that appear to have evolved from the O27 lineage [8], making the need for a method to demonstrate strain relatedness highly important. In a hospital setting knowing the

Clostridium difficile was initially thought to be part of the normal flora and C. difficile infections were miss identified as Staphylococcus aureus or Candida albicans. The C. difficile toxin was later identified in 1977 after a clinical trial using clindamycin caused patients to have diarrhea. The next year, in 1978, antibiotic use was quickly discovered as the major risk factor (Brymer, 2007). Clostridia belong to the phylum Firmicutes and comprise a heterogeneous group consisting of at least 12 lineages. Morphological and phenotypic properties that have traditionally been used to define the genus include the formation of endospores, anaerobic energy metabolism, an inability to reduce sulfate to sulfide, and a Gram- positive cell wall structure. Clostridia usually form spores only under anaerobic conditions, they grow better anaerobically than in air (Stevens,2015). Clostridium difficile infection is the most common infectious cause of diarrhea in the Intensive Care Unit.

The presence of C. difficile in the bacterial flora of human gut normally causes no harm. C. difficile represents a problem when overgrows due to the used of antibiotics, which destroy the normal flora that held C. difficile in balance. This makes C. difficile grow faster and colonizing the human colon. When colonization occurs, the toxins from C. difficile cause diarrhea and life-threatening colitis (Nazarko, 2015, p. 21).

According to Aziz (2013), “C difficile is a spore-forming, Gram-positive anaerobic bacillus that is the most common cause of diarrhea in hospitalized patients” (p.1). C diff. infection occur when a patient is being treated with an anti-biotic for a particular disease and this anti-biotic depletes the number of good bacteria to an extent that it creates an environment suitable for an opportunist pathogen like a fungi or bacteria to take over and infect the patient with a different type of illness. In hospitalized patients, especially those who are taking a lot of antibiotics, normal bacteria in their guts can be killed and in this case leaving C-diff to multiply and cause an infection. Diarrhea and stomach cramps are one of the symptoms of C.diff infection. I some cases serious inflammation of the colon can also occur. The infection can be acute or chronic which means that the infection can last 2-3weeks or more. Isolating infected patients helps to reduce the spread of this infection to other patients in the hospital. Health care workers should also use the appropriate protective equipment to assess the isolation rooms and have these patients not

“Recurrent C. difficile infection is defined as an episode of C. difficile that occurs 8 weeks or less after the onset of an initial episode of CDI that resolved with or without therapy.” (Gerding et al. 1986) Patients present with a variety of clinical findings ranging from an asymptomatic carrier state to the development of mild to moderate non bloody diarrhea. Typically, individuals experience the common symptoms like abdominal pain, malaise, nausea, vomiting, dehydration, and fever.

Most of the public have heard of broad-spectrum drugs, especially in terms of antibiotic resistance, because they fight a wide range of bacteria but also kills normal flora in the gut (Haddox, 2013). The loss of this gut flora can lead to an abnormal growth of harmful bacteria such as clostridium difficile (C-Diff). The four “C” antibiotics that have a high risk for patient to develop C-diff are clindamycin, cephalosporins, coamoxiclav, and ciprofloxacin (Haddox, 2013). These antibiotics have the highest risk of leading to C-diff development, however all antibiotics increase a patient’s likelihood of a C-diff infection. This effect can last up to 12 weeks post antibiotic administration (Haddox, 2013).