Clostridim difficile was first isolated in1935 by George and his colleagues from a stool found in a healthy infant by the name of Hall and O’Toole (Heinlen and Ballard, 2010). Yet in 1978, C.difficile was known to be associated as disease in human’s antibiotic-associated diarrhea (Heinlen and Ballard, 2010). It is 2 types of C. difficile: one that exists in spore form and the other in vegetative form. Depending on the type of form it exist in, allows it to grow in a certain environment. It is also a gram positive rod bacterium. When Clostridim difficile exist in a spore form, it can live in harsh conditions and in common sterilization techniques (Heinlen and Ballard, 2010). When C. difficile exist in spore form, it will be resistant to temperature …show more content…
difficile (Heinlen and Ballard, 2010).
In the United States, Clostridim difficile has cost the healthcare system possible more than 1 billion dollars annually, and in developing countries it is the leading cause of illness that occurred in hospitals; with cases that have C. difficile link to it is estimated to cause over 3600 dollars in health care fees (Heinlen and Ballard, 2010). According to data that was reported by Center for Disease Control and Prevention, C. difficile start from a low of 31 cases out of 100,000 people per yer in 1996 to an increase in 2003 with 61cases out of 100,000 people per year (Heinlen and Ballard, 2010). In the United States alone, it have been estimated that 500,000 cases have occurred per year (Heinlen and Ballard, 2010). C. difficile infections (CDI) have also increased by 25% with an estimate of 15,000- 20,000 people die per year in
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difficile to treat host from this pathogen. They use C. difficile strains, plasmids and conjugal transfer system to conjugate C. difficile gene. C. difficile strain 630 and VPI 10463was used and they first grew it anaerobically in Brain Heart Infusion media or it can be grown on an OXOID agar with 0.5% yeast extract and 0.1% cysteine, BHIS (2013). They also grew the bacteria in modified HySoy Medium by fermentation of 4-81. They then designed synthetic TcdA and TcdB genes using double allelic substitutions in GT catalytic site residues and used 630 toxin genome sequence for the recombinant genes (Donald, et. al, 2013). After synthesis TcdA and TcdB genes with their full length was subcloned as 8.1 kb and 7.1 kb NdeI-BlII fragments into pMTL84123 vector and E.coli strain Stb12 was the recombinant plasmid used (Donald, et. al, 2013). PCR was done using 5’ and 3’ flanking ends of the sites NotI and NdeI RE. Toxin A and B mutants was further mutated to modify or revert the toxins by site-directed mutagenesis using internal 2.5 kb NdeI-HindIII or 3.3 kb NdeI-EcoNI fragment subclones (Donald, et. al, 2013). Clostridim difficile was then conjugated by conjugal transfer of plasmids from E.coli and centrifugation was done to harvest the bacteria (Donald, et. al, 2013). Transformation that appeared on the media or agar was purified onto a BHIS agar and tested genetically modified toxins (Donald, et. al, 2013).
Clostridium difficile is a particularly challenging and difficult infection to control. Because Clostridium difficile spores can live on dry surfaces for long periods of time, teaching must include the importance of cleaning surfaces and
Clostridium difficile is a gram-positive bacterium which causes diarrhoea. It also known as antibiotic associated diarrhoea and also pseudomembranous colitis. The bacterium secretes large protein toxin that also causes toxic mega colon. Clostridium difficile is caused by when a person is given one of the following antibiotics: Cephalosporin, penicillin (particularly Ampicillin or Amoxicillin), Clindamycin and Fluoroquinolone. The antibiotic will remove the entire normal flora in the colon. The lack of normal flora will make the person vulnerable to infection especially to Clostridium difficile because Clostridium difficile produces hardy spores
Clostridium difficile is a spore forming, anaerobic, toxin-producing, gram-positive bacillus that is the most common cause of nosocomial, antibiotic-associated diarrhea (15-25%).1,2,3 The pathogenesis of C. difficile-associated diarrhea (CDAD) is the result of broad spectrum antibiotics, such as clindamycin, flouroquinolones or ceftriaxone, which reduces the population of normal bowel flora and allowing for an overgrowth of C. difficile.1,2 The toxins synthesized by C. difficile, A and B, lead to the inflammation and damage of the intestinal mucosa creating the symptoms of C. difficile infection (CDI). These symptoms can range from asymptomatic carriers, to mild diarrhea to sudden and occasionally deadly colitis. The clinical practice guidelines for the treatment of CDAD recommends the use of metronidazole (MET) and vancomycin (VAN) that is dependent upon the severity of the CDI.1,2,3
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 is an obligate anaerobe, gram positive bacteria that has the ability to form spores. Clostridium difficile is the leading cause of nosocomial antibiotic associated diarrhea worldwide. C. difficile is an opportunist pathogen that utilizes many factors to infect and damage the host, often with overwhelming consequences. Symptoms range in severity from mild diarrhea to pseudomembranous colitis and toxic megacolon, the most severe form of disease, which often results in death (Awad, 2014).
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?
Clostridium difficile, a nosocomial pathogen, is of critical importance. By 2010 it was the most prevalent healthcare-related pathogen globally [1], accounting for 20-30% of antibiotic-associated diarrheal cases in healthcare settings [2]. Symptoms of C. difficile infection (CDI) are significant and include severe diarrhea and dehydration. In more serious cases, CDI can result in pseudomembranous colitis, bowel perforation, sepsis and even death [3, 4].Beyond serious impact upon patients, CDI is costing multiple billions of dollars in hospital care in the United States alone [5]. Clearly the need exists to identify and characterize the infection and toxicity pathways of C. difficile.
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 (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.
This paper will mainly explain what Clostridium difficile is, its causal agent, epidemiology, ways of transmission, some clinical features, diagnoses and how to test for the bacterium, treatment, prognosis, and preventative measures. There are treatments available for this
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 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.
While most people on antibiotics are at the greatest risk of developing Clostridium difficile, there are specific groups of people who also have a chance of being infected. This includes the older population, people who 's immune system is compromised such as cancer patients, people who have a feeding tube, and people who have come in contact with infected patients (Fordtran, 2006, pp. 3). Most cases of Clostridium difficile can be found in a healthcare setting. This includes nursing homes where the older population resides, hospitals where immune compromised patients are receiving treatment as well as patients on antibiotic therapy. (Mayo Clinic Staff, 2017). The bacteria is found in the stool. It is then passed from one person to another through contaminated surfaces. If a person touches a contaminated surface, then their contaminated hand touches their mouth or any other mucus membrane, they are at risk of developing the infection. Clostridium difficile can survive for long periods of time on these contaminated surfaces which is why healthcare settings have the highest record because germs spread quickly (Mayo Clinic Staff, 2017). When in contact with
Clostridium difficile is shed in excrement. Any surface, gadget, or material (e.g., cabinets, showering tubs, and electronic rectal thermometers) that gets to be defiled with excrement may serve as a repository for theClostridium difficile spores. Clostridium difficile spores are exchanged to patients predominantly through the hands of medicinal services staff who have touched a polluted surface or
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