Clostridium Difficile Analysis

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 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

Ingestion of the endospore causes infection. Once it reaches the preferred anaerobic environment of the gut, the endospores germinate and begin releasing toxins A and B (Burns & Minton 2011). The presence of C. difficile does not necessarily mean infection. A patient can be positive for C. difficile but have normal stool, which means there is colonization without infection. Patients who have the C. difficile pathogen without experiencing any symptoms allow it to be passed along undetected which contributes to the ongoing spread to others. Only when toxin A and toxin B are released at suitable levels does C. difficile become pathogenic to humans. Once infected, typical symptoms include watery diarrhea, abdominal pain, colitis, fever, and fecal leukocytes. Moderate to severe Clostridium difficile infection (CDI) consist of profuse diarrhea, abdominal distention, leukocytosis, systemic inflammatory response, pseudomembranous colitis, megacolon and death (Sunenshine & McDonald, 2006). With the combination of a highly resilient endospores, and asymptomatic carriers, this allows C. difficile to persist in the environment and spread to patients with compromised immune systems, or older patients who have a high risk of contracting CDI with a higher severity than healthy adults (Laffan, Bellantoni, Greenough, Zenilman, 2006).

These single celled tube-like organism finds a home in the gut of every human during their lifetime. If the person affected does not have the proper bacterial flora to balance Clostridium difficle, the bacteria will manifest itself. The bacteria produces a toxin that breaks down the outer and inner linings of the small and large intestine causing the condition, Clostridium difficle Colitis. The impaired intestine will cause the body to have up to 20 bowel movements a day. The bowel matter will eventually turn to water and blood, causing extreme malnourishment and dehydration. The bacterial infection, if not intervened will cause morbidity. According to Roos (2015), the CDC reported there are half- million cases and thirty-thousand deaths each year in the United States. Clostridium difficle is one of the world’s leading causes of deaths in assisted living facilities (Roos,

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 has infected up to 500,000 people in the United States every year. Clostridium difficile is a bacterial infection it can cause diarrhea and also a fever. It has also caused death among people. There has been a recorded 14,000 deaths from Clostridium difficile a year.

Clostridium difficile is a gram positive; spore-forming rod and it is part of the flora neonates. It contains 3 types of toxins- Toxin A, Toxin B and binary toxins. Toxins A and B are proinflammatory and cytotoxic, they are the primary markers for the identification of C. difficile as they cause the disturbance of actin cytoskeleton and impairment of tight junctions in human epithelial cells, resulting in fluid build-up and extensive damage to the large intestine (Carter, Rood, and Lyras, 2010).

Clostridium difficile (C. difficile) is a pervasive and troublesome bacterium in healthcare. If left untreated it can lead to a plethora of complications—acute, chronic, and even fatal. C. difficile is a gram positive bacillus (with a capsule) and has ideal conditions for growth at around 37°C in an obligate anaerobic environment. In its vegetative state, C. difficile contains multiple flagella for motility within the intestinal tract; 1 however, once outside of its ideal environment, or through active shedding, it’s left latent within its hardy endospore until it is in its ideal environment once again.

Clostridium difficile is a gram-positive spore-forming bacteria; first isolated and published in 1935 by Hall and O’Toole. This was accomplished from the stool of a healthy infant. However, it was not until 1978 that C. difficile was identified as being associated with many cases of antibiotic-resistant diarrhea.1 C. difficile has since become one of the leading causes of nosocomial infections in the United States. A study conducted in 2015 has estimated that C. difficile infection has an incident of 453,000 (95% confidence interval) in the United States.2 This has placed a tremendous burden on the US healthcare system. According to data from 2008, C. difficile infections have accumulated an excess cost of $4.8 billion to the US healthcare system.3

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).

The answer is that it cannot. Clostridium difficile cannot. However, the diarrhea from the C. diff can. To prevent it, one must work backwards, returning to the transmission of the illness. The question is then how is it passed on to other people? The answer is simple: lack of proper handwashing. By not properly washing the hands, the method of transmission become the nurses’ hands. But that does not necessarily account for the spores found in the bedsheets. In that, one has to realize that a patient with diarrhea may or may not have Clostridium difficile colitis. When that is realized, great care should be taken with the bedsheets of that individual, by taking care not to shake the sheets to prevent dispersal through the air. The nurse must then once again follow proper handwashing procedures after disposal of the dirty linens. Nothing can affect the flora to prevent all bouts of C. diff. That includes antibiotics, the number one cause of Clostridium difficile. But because antibiotics are sometimes necessary for survival, the patient must be encouraged to intake probiotics while on antibiotics. Similarly, if the antibiotics are not needed, the patient should not be taking them. C. diff is a superbug, an illness that antibiotics cannot help. And by purposely taking antibiotics for no need causes more problems than the patient should want to deal

C. difficile is a Gram-positive obligate anaerobic or microaerophilic, rod-shaped bacterium. It is found in nature in water, air, human and animal feces, on most surfaces (especially in hospitals) and most prevalently in soil. C. difficile causes mild to severe diarrhea and intestinal conditions like inflammation of the colon (pseudomembranous colitis). C. difficile is the most frequent cause of infectious diarrhea in hospitals and long-term care facilities in the U.S. and many other nations. C. difficile is found in some healthy people but is not a major constituent of the microflora in colons of healthy adults but can grow to large populations in people that are treated with antibiotics, especially broad-spectrum antibiotics. This is because the antibiotics kill off the

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

Clostridium difficile (C. difficile) is a gram positive, rod shaped, anaerobic bacteria. It causes a range of diseases ranging from benign diarrhoea to pseudomembranous colitis which is inflammation of the colon (1). Our intestinal homeostasis is maintained by several elements such as a complex microbial community which accounts for 70% of total microbiota in humans, tight epithelial barrier and immune tolerance. Certain antibiotics can disrupt this homeostasis resulting in an increase in colonisation from pathogens e.g. C. difficile leading to a development of full phenotype C. difficile infection (CDI) which requires the previous use of antibiotics (1,2, 3).

GOPAL RAO G., C.S. MAHANKALI RAO, I. STARKE. 2003. Clostridium difficile-associated diarrhoea in patients with community-acquired lower respiratory infection being treated