Clostridium Difficile Analysis

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.

According the MacDonald Clifford (2013), the pathogen has been responsible for causing incident infections. In 2011, the clostridium difficile did cause approximately 453,000 incident infections, and also it was associated with approximately 29,000 deaths in the United States. This is

A patient diagnosed with CDAD, must discontinue the use of the prior antibiotics. “Excessive antibiotic use and the lack of available treatment options remain major challenges in the prevention and treatment of CDAD. Antibiotic use is both a risk factor for CDAD and the mainstay of treatment” (Crawford, Huesgen and Danziger 934). The primary antibiotic treatment is determined by the patient’s white blood cell count (WBC). Metronidazole and Vancomycin are the most common choices (Keske and Letizia 331). Current research has suggested that Fidaxomicin is well tolerated and has been effective in patients who have presented with a recurrent CDAD. Fidaxomicin is still in the clinical trial phase of

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

There are many bacteria that do not go through cellular respiration; there are also some that do. These tiny organisms live in every habitat, including the air we breathe. Prokaryotes are grouped according to their need for oxygen. Obligate anaerobes are prokaryotes that cannot live in the presence of oxygen. In fact, exposure to oxygen for even a short length of time will kill these prokaryotes. They produce methane and are found at the bottom of lakes, in marshy areas, and in the digestive tracts of herbivores and omnivores. Bacteroides are a species of obligate anaerobic bacteria that live in mammalian intestines and help break down lipids and proteins into their smaller subunits, monomers. Clostridium difficile bacteria are often found

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 (C-diff) is a bacterium of the intestine that usually develops after the start of antibiotics in at risk patients. C-diff causes inflammation of the intestine by irritating the lining of the intestinal wall. C-diff can cause many symptoms with lose stool multiple times throughout the day for more than two days being the most common. Severe infections can lead to hemodynamic changes in the body that could lead to hospitalization and/or surgery. The spores from C-diff can be passed on from months if an affected surface is not properly cleaned after being exposed to the bacteria. Proper hand washing must take place to avoid ingestion of the bacteria. C-diff is a form

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.

The presence of C. difficile in the bacterial flora of human gut normally causes no harm. C. difficile represents a problem when overgrows due to the used of antibiotics, which destroy the normal flora that held C. difficile in balance. This makes C. difficile grow faster and colonizing the human colon. When colonization occurs, the toxins from C. difficile cause diarrhea and life-threatening colitis (Nazarko, 2015, p. 21).

In the search of patents, monoclonal antibodies (mAbs) used for the treatment of Clostridium difficile infections (CDIs) were chosen in respect to previous research conducted for mAbs. In the U.S. alone, there are roughly a quarter of a million CDI related cases reported by clinics. Some patients develop severe symptoms of the infection and require extended medical treatment increasing medical expenses (Wilkins & Lyerly, 2003). Several strains of the bacterium have shown to be hypervirulent and have developed resistance to various antibiotics (Hernandez et al., 2015). In order to treat the tenacious bacterium, research on treatment alternatives for CDI has been in high demand. Relatively recently, Progenics Pharmaceuticals, Inc has applied and been approved for a patent for mAbs used to treat CDIs (Progenics Pharmaceuticals Submits Patent Application for Antibodies for the Treatment of Clostridium Difficile-Associated Infection and Disease, 2015).