C Diff Case Study

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).

The patient is positive for C. Diff, this is causing her to have diarrhea. The diarrhea is causing the patient to be dehydrated because she isn’t retaining any water. This is causing her kidneys to not function properly.

A.C. is a 79-year-old man living in a long-term care facility. He has had multiple medical diagnoses, including congestive heart failure (CHF), chronic obstructive pulmonary disease (COPD), and stroke. He is bedridden and receiving enteral tube feedings. He has chronic diarrhea thought to be related to his tube feedings. He receives digoxin (Lanoxin) and furosemide (Lasix) to manage his CHF.

In order to diagnose this patient with this bacterium, I would place an order for a blood culture. Blood cultures are indicated in patients with sepsis, severe skin and soft tissue infections, or unstable vital signs; example massive organ failure. Blood cultures

C. difficile is a spore-forming and strict anaerobe gram-positive bacillus [4], capable of excreting pathogenic toxins, as discussed below [3]. This spore forming ability is a method of bacterial persistence within the human body. C. difficile is able to resist and survive a variable environment when various other microbes cannot. Three important factors affecting the risk of CDI include the use of antibiotics, length of hospital-environment exposure and age [1]. The use of broad range antibiotics affects the composition and lively-hood of normal

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.

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 bacterium that infects humans, animals, water, soil, feces and food products. Clostridium difficile also known as C. diff or C. difficile is an asymptomatic infection due to the spore-forming bacterium which causes inflammation of the colon. C. diff is very contagious; it is a microorganism that can be spread from person to person by touch or direct contact. Symptoms with severe infections cause watery diarrhea ten to fifteen times a day, rapid heart rate, blood or pus in stool, dehydration, kidney failure, increased white cell count and, abdominal cramping. Symptoms with mild to moderate infections cause watery diarrhea three to more times a day and abdominal cramping. Approximal half a million people get infected with C. diff each year in the United States.

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.

Checking in to the hospital comes with a heavy price tag, and sometimes you get more than what you bargained for. As highly trained doctors, nurses, and staff make their way through the hospital, they carry with them microbial agents of disease. Although regarded as centers for treatment and prevention, hospitals are also known to harbor nosocomial, healthcare-associated, bacterial infections. These infections can be a result of overused or inappropriately used antibiotics and the breaching of infection containment policies by patients and staff. Though health-care-associated infections have been decreasing, one infection inciting nosocomial bacterial, Clostridium difficile has been rampant. It is important that inefficiencies in health-care be met with stringent efforts for prevention as they may lead to distressing financial, emotional, and medical repercussions.

Clostridium difficile infection is a suprainfection cause by prolong use of antibiotics. Board spectrum antibiotic such as Penicillins, clindamycin, and cephalosporins are the antimicrobial drugs most commonly associated with C difficile colitis. According to Owens, in his research, C. difficile is primarily acquired in hospitals. Spread by spores, it can colonize a patient’s gut after helpful gut bacteria are killed by antibiotics. Its toxins can cause severe diarrhea and colitis, and it can be fatal (Owens 2013). On the other hand Kim in his research agreed clostridium difficile infection has been considered a hospital-acquired infection. However, a recent population-based study found 41% of CDIs were actually community acquired. It is becoming apparent that community acquired CDI affects populations previously thought to be at low risk; younger patients and patients who had no exposure to antibiotics in the 12 weeks before the infection. Thus, it is necessary to advocate and teach patient about

1. Staphylococcus aureus/MRSA This case describes a 32-year old female patient who underwent a colon resection due to her diagnosis of colon cancer. The patient has a history of a leukopenia. The last time she was examined, her white blood cell count was 2,300 white blood cells per mm3. The surgery required her to remain on bed rest, and she was given an indwelling catheter as pain leading to lack of mobility made it difficult for her to ambulate to the restroom.

The incidence and mortality associated with Candida bloodstream infection (CBSI) have increased over the past two decades, despite the introduction of several extended-spectrum triazole and echinocandin antifungal agents for prophylaxis, empiric and targeted therapy [1],[2]. Likewise, CBSI has emerged as an important public health problem with one the highest costs of any healthcare-associated infections. Candida has been described as the fourth most common cause of healthcare-associated BSI surpassed only by coagulase-negative staphylococci, Staphylococcus aureus and Enterococcus [3], [4]. CBSI has the highest pathogen related mortality [4] because the signs and symptoms of disease are non-specific. Moreover, the general indications for ordering a blood culture are fever and leukocytosis, which are absent in around 20% and 50% of patients with CBSI, respectively [5]. Early identification of CBSI is critical and still depends on blood cultures, despite the fact that is an insensitive technique [3] and that prophylactic or empiric antifungals may render false negative results. (???)

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).

C & C Grocery’s initial organizational structure operated under a vertical linkage. Vertical linkage is utilized to “coordinate activities between the top and bottom of an organization and are designed primarily for control of the organization” (Daft,2013) Store managers were responsible for the grocery line, front-end department and general store operations but had little knowledge about merchandising, meat and produce. Instead, their duties included cleanliness of store, employee appearance, and sufficient checkout service and price accuracy. Store managers wanted to be trained in management skills to allow them opportunity