C. Difficile Infection Research Paper

Infection is when foreign bodies such as bacteria, fungi and parasites invade your body these germs can cause disease and can even lead to amputation or even death in the host body. An infection may cause no symptoms or it may cause symptoms where you become really symptomatic and be hospitalized.

Clostridium difficile or otherwise known as C.diff. is a life threating infection that can cause a wide range of symptoms. Patients can experience anything from diarrhea to inflammation of the colon that can lead to death. In the past few years, Clostridium difficile infection rates have increased here in the United States causing great concern about the effectiveness of current treatments. For the past fifty years, the medical community has been investigating other areas for better treatment options.

First discovered in 1935 by Hall and O’Toole, Clostridium difficile (C.diff) earned its name from the Latin difficilis, due to its difficulty in culturability when it was initially isolated. Though its cytotoxic nature was acknowledged, it wasn’t until 1978, when the antibiotic clindamycin was being widely used, that C. diff was recognized for causing disease in humans. Since then, the incidences of C. diff infections have increased significantly, becoming an epidemic in both Canada and the United States.

difficile infection and the type of treatment depends on the severity of the illness. If possible, the antibiotic that has caused the problem should be stopped. People with more severe diarrhea will normally be given an antibiotic that is known to kill C. difficile. According to American College of Gastroenterology, patients with mild-to-moderate C. difficile infection (CDI) should be treated with Metronidazole 500 mg. orally 3 times per day for 10 days while patients with severe CDI should be treated with Vancomycin 125 mg. 4 times daily for 10 days. As with any case for diarrhea, fluid intake is critical. If you had the C. difficile infection once, you have about a 1 in 4-5 chance that you will have the infection again in the future. Unfortunately, there are no licensed vaccines available that can prevent C. difficile infection at this time.

Hospital acquired infections are best described as: “Nosocomial infections are hospital acquired infections (HAI) also known as health care associated

Furthermore, in the past 10-15 years, Clostridium difficile infection (CDI) has emerged as an increasingly important infectious disease worldwide. C. difficile is an antibiotic-associated bacteria that causes asymptomatic

Clostridium difficile is a bacterium that is found in the human colonic flora that can cause diarrhea and more serious conditions, such as colitis. This occurs if the physiological bacterial flora is changed or damaged due to prolonged antibiotic use and if the concentration of C. difficile increases significantly. The prolonged antibiotic use enables C. difficile to multiply and produce large amounts of dangerous toxins. Therapy for those who suffer from this includes rehydration, immediate stop of the causative antibiotic (usually clindamycin or amoxicillin), and new antibiotics to reverse the symptoms such as vancomycin. C. difficile is easily transmitted within hospital settings because its spores are resistant to the commonly used alcohol

(Tortora, Funke, & Case, 2013, p. 414) Most hospitalized patients will be immune compromised to some extent and the hospital, by nature, is a pathogen rich environment. Ongoing efforts to minimize pathogens in the environment by all hospital employees, patients and visitors are crucial. Infection control nurses and/or committees should work continuously to identify and eradicate possible infection sources. Equipment, especially respirators and humidifiers must be kept scrupulously clean lest they become reservoirs for microbial growth. (Tortora, Funke, & Case, 2013, p. 417) Strategically placed signs warning visitors to avoid entering the hospital if they are unwell, strict compliance with standard precautions, private rooms and special ventilation systems for contagious patients are all essential in the effort to minimize contamination. Occasionally, airborne and droplet precautions are necessary, but most pathogens responsible for common HAIs are spread by direct or indirect contact. Chain of transmission is therefore the parameter over which nurses have particular influence, as nurses have the most direct, hands-on contact with

Most of the germs causing bacteria are transmitted to the patient by hands during the patient care (World Health Organization, 2016). The surfaces in patient rooms, the health care workers (HCWs) clothing, and the instruments used by the HCW can be contaminated. Proper hand hygiene is needed to prevent or reduce the transmission of HCAIs in patients. Urinary tract infection, surgical site infection, pneumonia and infections of the bloodstream can be contacted through improper hand hygiene. HCAIs are the major cause of morbidity and mortality (Office of Disease Prevention and Health Promotion (ODPHP), 2016). These infections cost the health care system billions of dollars every year and several losses of lives. It can have disastrous emotional, financial and medical impact on patients and their family members. These infections jeopardize the safety and care for patients (WHO, 2016). Hand hygiene is the first line of defense against infections. Before contact with patient, hand hygiene should be performed by hand washing with soap and water or using an alcohol-based hand rub. Hands should be disinfected before patient contact, prior to and following the insertion of any invasive devices, before using gloves for central intravascular catheter insertion (Centers for Disease Control and Prevention (2016). Hand should be cleaned following checking vital signs, contact with mucous

Clostridium difficile infection (CDI) is the most common cause of antibiotic associated diarrhea (AAD). Rapid diagnosis of CDI is essential to prevent hospital spread of infection. The aims were to determine the prevalence of CDI among cases of AAD in Zagazig University Hospitals, identify risk factors, and evaluate real-time polymerase chain reaction (PCR) and enzyme immunoassay (EIA), against toxigenic culture (TC). Stools were collected from 150 patients with AAD. They were tested for TC, toxin A/B EIA, and C. difficile tcdA/tcdB genes. Thirty four toxigenic C. difficile isolates were obtained (22.7%) out of the 150 patients and those patients were considered positive for CDI. On the other hand, 6 non-toxigenic C. difficile isolates were obtained (4%), while culture of the remaining 110 patients (73.3%) did not yield C. difficile. The later 116 patients (77.3%) were considered negative for CDI. Analysis of risk factors revealed that advanced age, prolonged hospitalization, long duration of antibiotic intake, potentiated penicillins, 3rd generation cephalosporins, antibiotic combined therapy, liver cirrhosis, malignancy, proton pump inhibitors, enteral tube feeding, and cancer chemotherapy were significantly associated with CDI. Sensitivitiy, specificitiy, positive predictive value, negative predictive value, and accuracy of real-time PCR against TC were all 100%, however, values of EIA were 79.4%, 100%, 100%, 94.3%, 95.3%, respectively. Conclusion: CDI is an

Hospital acquired infections are diseases that people acquire while they are getting treatment for another illness in a hospital. To be considered as a hospital acquired infection, the patient must not have had the disease before admitted into the hospital. Hospital acquired infections are associated with different kinds of risk factors including the use medical devices such as endotracheal, bloodstream, and urinary catheters; surgical procedures; injections; contamination of the health care environment; transmission of communicable diseases between patients and healthcare workers; and overuse or improper use of antibiotics. The most common hospital acquired infections include infections of surgical site, catheter-related infections of the urinary tract, bloodstream infections, and ventilator-related pneumonia. These four categories of infections account for more than eighty percent of all hospital acquired

C. diff is an anaerobic, spore-forming, toxin-producing, gram-positive bacillus that causes infectious diarrhea (Walters & Zuckerman, 2014, p. 24). Since the biggest risk factor is use of antibiotics, avoiding multiple broad-spectrum doses is appropriate in primary prevention. Other interventions that fall under this strategy according to Mitchell, Russo, and Race (2014) include, early initiation of isolating the patient while using appropriate PPE and high levels of personal and environmental cleanliness. In a secondary prevention strategy you would want to test patients that develop diarrhea or loose bowel movements that have been exposed to antibiotics to ensure early detection for treatment. Lastly, in tertiary prevention you would want to focus on the treatment of current C. diff infection. Treatment includes but is not limited to antibiotics (e.g., Flagyl, oral Vancomycin, and Dificid), probiotics, hydration, and possibly surgery depending on the severity of the case. Additionally, adequate surveillance throughout each level of prevention is required to prevent spread or

It is very common for patients who receive antibiotic therapy for C. difficile infection to have a recurrence of infection. Mattila states, “Up to 35% of patients experience a symptomatic recurrence after discontinuation of antibiotics for CDI…Subsequent relapses occur in up to 50%-65% of patients” (Mattila et al., 2012, p. 490). These recurrences increase the number of hospital stays, increase potential for the spread of infection and can be dangerous for patients with multiple comorbidities, especially the elderly where we see the highest number of occurrences of C. difficile infection.

Medical management involves the use of vancomycin, which is effective only when delivered through enteral feeding (Walters & Zuckerbraun, 2014). C. difficile resistance drugs have been observed and are of concern given the increased prevalence of infection over the years and the subsequent requirement for antibiotics now. Reduced susceptibility to vancomycin has been seen with C. difficile isolates, however, it is not widespread at this time (Jarrad et al., 2015). One of the more displeasing issues related to C. difficile infection is the recurrence of the disease. This may be due to the standard treatment with vancomycin, which destroys the C. difficile bacteria but does not restore the patient’s colonic microbiome and gut flora, and/or impaired

difficile had received antimicrobials within 14 days prior the onset of diarrhoea and all had received antimicrobial in the past three months(9). Reports have shown that there are changes in the epidemiology of C.difficile with increase in incidence and severity of the disease in several countries (10). The change is often attributed to the emergence of a previously rare and more virulent strain BI/NAP1/027(11).This strain often has increased toxin production and a high prevalence of resistance to fluoroquinones, making it an important pathogen in the health care system