C. Diff

Clostridium difficile is a gram positive, spore forming anaerobic bacillus, which may or may not carry the genes for toxin A-B production (Nipa, 2010). These two types of protein exotoxins produced by the Clostridium difficile bacillus, toxin A and toxin B, can have an infectious form and a non-active, non-infectious form (Grossman, 2010). The infectious form can survive for a short duration of time in the environment. The spores can survive for a longer period of time in the environment and are not infectious unless and until they are ingested or are transformed into an infectious state (Nipa, 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

C-Diff is an anaerobic gram-positive spore forming bacterium, which affects and grows in the gastrointestinal tract after the normal intestinal flora, has been changed by antibiotic therapy or by contact through the fecal- oral route (Kelly & Lamont, 2014). The C-Diff organism, releases two different toxins, toxins A & B. Both toxins are cytotoxic for many different cells. Toxin B is more potent then A, both toxins cause increased vascular permeability by opening tight junctions between cells, which cause hemorrhage, these toxins also stimulate the

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.

Clostridium difficile involves a gram-positive spore-forming bacterium, which is a normal element of the colon flora in people. The Clostridium difficile can cause antibiotic-associated diarrhea when the competing bacteria in the gut flora are all killed by antibiotic treatment. The Clostridium difficile infection is one of the serious healthcare-related infection and also a rising health care problem. In the early 1970s, the Clostridium difficile has been known to have the ability to cause pseudomembranous colitis. As stated, the infection is the most cause of nosocomial infectious diarrhea (Aktories & Wilkins, 2000). Individuals that are colonized with clostridium difficile serve as the reservoir for infection and this is by contaminating the environment with spores of such bacteria. This will lead to the spread of the organism on the health care worker’s hands or even through the use of medical equipment. In this paper, we are going to focus on the effective prevention strategies for clostridium difficile. What are the effective prevention strategies for clostridium difficile?

CDI cannot be treated with many antibiotics, and as early as 2000 another strain appeared that was resistant to even more antibiotics, including fluoroquinolones (“Antibiotic/Antimicrobial Resistance.”). This new strain creates more toxins and can show up in people not normally considered at risk for CDI infection, like those who have not been hospitalized or treated with antibiotics (“C. difficile infection.”). This aggressive strain only adds more danger to an already resistant bacteria. As antibiotics became more common, they were prescribed for thousands of common illnesses. Over time, Clostridium difficile has built up a resistance to antibiotics to become a major concern. Even more frightening, it has started to appear in the community. In fact, the Centers for Disease Control rate it as an urgent threat. Superbugs like CDI are becoming a more ever-present threat and we must continually work towards newer and more effective treatments to counteract the bacterias frightening ability to resist us (“Antibiotic/Antimicrobial Resistance.”). CDI is just one of many superbugs, however, and others pose just as great a

Clostridium difficile is a highly contagious infection of the colon that's hard to contain and occurs in many health care facilities. With the proper interventions, it can be prevented and contained. The purpose of this paper is to discuss an article about C. diff and give suggestions on how to avoid an outbreak at a health care facility.

Ever since I’ve been working in long-term care facilities and hospitals for almost fourteen years, my multiple encounters with Clostridium difficile become prevalent as the years go by. The incidence of its unprecedented spread has increased dramatically in the past decade. This observation was proven by the recent National and State Healthcare Associated Infections Progress Report, published March, 2014 by Centers for Disease Control and Prevention (CDC) which suggests that C. difficile has replaced methicillin-resistant Staphylococcus aureus as the most common cause of the health-care associated infection, specifically showing the national standardized infection ratio of 0.98 for hospital-onset C. diff infection against 0.96 for MRSA bloodstream infection. The etymology of the rising new “superbug” Clostridium difficile, also known as C. diff is derived from the Greek word klōstēr which means spindle and Latin difficile, “difficult, obstinate”. The genus name, Clostridium is used because under the microscope, the colonies of these bacteria looks like spindles used in cloth weaving and long sticks with a bulge at the end. The species name difficile owing to the fact that when first identified by Hall and O’Toole in 1935 the organism was hard to isolate and grew slowly in pure culture. Based on Bergey’s Manual of Systematic Bacteriology, 2nd Ed., C. difficile belong to domain bacteria, phylum Firmicutes, class Clostridia, order Clostridiales, and family

Among C. difficile, there are a number of virulence factors with varying mechanisms of pathogenicity. Most notably, this bacteria produces 1-3 toxins during a C. difficile infection (CDI): an enterotoxin (toxin A/ TcdA), a cytotoxin (toxin B/ TcdB), and a binary toxin (C. difficile transferase or CDT).1, 4, 5 CDI can occur with the presence of either toxin A, toxin B, or both; additionally, binary toxin is only found in particular strains and assists in bacterial adherence to host

Clostridium difficile is a gram positive bacterium responsible for over 10,000 deaths annually in the United States alone. C. difficile is an opportunistic pathogen that has progressively become antibiotic resistant in several strains. The bacterium strives in hosts currently taking antibiotics where there is no competition between commensal microbiota. Common known symptoms of C. difficile infections (CDIs) include diarrhea, fever, and toxic megacolon. Primary virulent factors of the bacterium currently being researched are the endotoxins, C. difficile toxin A (TcdA) and B (TcdB). Both toxins bind to receptors of gut epithelial cells and are endocytosed leading to the inactivation of Rho type GTPases. With the activity of these enzymes nullified, the cytoskeleton of cells are unstable and eventually die (Hernandez, et al., 2015).

C. diff is a gram-positive, rod shaped bacterium. It is also spore forming and anaerobic, which means that it is able to live in dirt for up to two years. Human and animal feces are where this bacterium is most commonly found. These are not the only places though; C. diff can also be found in soil, air, water, and processed meat. C, diff can be found in many healthy people intestines or colon. You can carry the bacteria with no symptoms because the millions of good bacteria in you are able to keep it under control. C. diff because present and starts to cause problems when you take antibiotics. The antibiotics kill off the good bacteria in you allowing the resilient C. diff to overpopulate. The spores’ produce when antibiotics attack the bacteria (APIC). The antibiotics that most commonly cause C. diff are fluoroquinolones, cephalosporins, penicillins and clindamycin (Mayo Clinic, 2016). Being on antibiotics is not the only way to get infected. C. diff is highly contagious. If people are not washing their hands thoroughly it can easily be spread along any surface and even into

difficile infection, but all of these methods have limitations and some of them are now considered suboptimal(2). The ideal laboratory test for CDI would be sensitive, specific, rapid, simple to perform, and inexpensive. Culture Just after the discovery of the pathogenic role of C. difficile proposed a selective agar plate called CCFA (cycloserine cefoxitin fructose agar) for the isolation from stool specimens. The selective agents are cycloserine at a concentration of 500 mg/L and cefoxitin at 16 mg/L. Culture is the most sensitive method but it is not very specific due to the possibility of isolating non-toxigenic isolates (14). Fecal diagnostic tests anaerobic toxigenic culture of C. difficile and the cell culture cytotoxicity assay, with neutralization with clostridial antitoxin, are the most sensitive for diagnosis of CDI but time-consuming (5). For many years, cell culture cytotoxicity neutralization assay (CCCNA) was the accepted gold standard. By this method, stool filtrates are inoculated onto a monolayer of a cell culture in wells with and without C. difficile antitoxin. CCCNA is quite specific for CDI. However, the assay is expensive, lacks standardization among laboratories and is generally unavailable outside the research setting (11). The enzyme immunoassay (EIA) became broadly used because of its rapidity in performance, but EIA used for toxin detection lack sensitivity and are considered suboptimal for diagnosing C. Difficile infection (11). A laboratory assay measuring the clostridial protein, glutamate dehydrogenase (GDH), represents a rapid,

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).