Clostridium Difficile Infection: The prescription for health

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 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 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 difficle is an opportunistic bacterium that can overgrow in immunocompromised individuals and become a difficult condition to manage. Clostridium difficle Colitis remains challenging for medical professionals due to the bacteria’s rapidly developing resistant and the immunosuppressed state the patient is in. The bacterial infection is more prevalent in the elderly community and immune compromised individuals in particular

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, or C. difficile for short, are words that every healthcare worker hates to hear that their patient has, or may potentially have. This spore forming bacterium has significant healthcare-associated infection potential. An especially virulent strain has affected health care facilities throughout the U.S. and North America in the past few years. What C. difficile is, its symptoms, how it is transmitted, and the prevention transmission are important issues to all healthcare workers. These questions and issues will be covered in this paper.

Each year in the United States, many people require hospitalization due to various medical reasons. Often times, patients must undergo a course of antibiotics to treat the medical condition that warranted the hospitalization. The combination of the necessity to be admitted to a health care facility along with the administration of an antibiotic may result in a Clostridium difficile infection (CDI). The purpose of this paper is to provide an overview of a CDI, including an overview of the microbiology of Clostridium Difficile (C- diff), as well as the epidemiology, pathophysiology, signs, symptoms, treatment and prevention of the infection.

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).

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

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 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 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).

Studies have identified different genera of bacteria which are present in the microbiome and their role in nutrient intake. Gut microbiota has 3 main enterotypes Prevotella, Bacteroides and Ruminococcus, there is a strong correlation between the concentration of each bacterial community and the dietary constituents. A diet high in carbohydrates and simple sugars would also indicate and reveal a greater concentration of Prevotella whereas a diet high in protein and animal fats would present a higher concentration of Bacteroides in the gut. A long term change in the diet would permanently shift the concentration of bacteria in the gut to accommodate the new nutrient uptake. This would then change the bacterial barrier in the intestine which could make it more vulnerable due to reduced species richness.

Clostridium difficile infection is a major case where fecal microbiota transplantation is used. The division or interruption of the microbiota that’s in the gut, resulting from the use of some antibiotics, is what mainly causes this infection. Environmental spores are yet another thing that could also cause this infection. For a while now, this infection has become an increasing problem to the health of the public. It is treated with certain antibiotics, although in some cases the use of these antibiotics can cause a regression of the disease once the patient is taken off the medication. Ultimately in some people this disease can keep coming back and will be never ending. People with this abstinent CDI want FMT therapy; they want this treatment to be available. Abstinent and arduous CDI requires FMT but it does need more development. People have shown others that FMT can cure them. The CDI epidemic has required FMT as a procedure, and needs to be evaluated. Even though the pharmaceutical industry has not expressed interest. It is the patients who require FMT that has created the