Clostridium Difficle Research Paper

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 (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

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.

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.

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

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).

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 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

Clostridium difficile is a highly contagious infection of the colon that's hard to contain and occurs in many health care facilities. With the proper interventions, it can be prevented and contained. The purpose of this paper is to discuss an article about C. diff and give suggestions on how to avoid an outbreak at a health care facility.

Doctors have found a way to treat and/or cure clostridium difficile by putting feces from a healthy person into a pill. Clostridium difficile, also known as C-diff, affects about 500,000 people per year, killing 14,000. Symptoms include nausea, diarrhea, and cramping that can often be crippling. There are antibiotics that can kill the germ, but they take down some of the good bacterias too. Fecal transplants can restore the healthy bacteria, but are given in expensive, painful procedures called colonoscopies. Enemas have also been attempted, but the treatment is not always effective.

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

Clostridum difficile is excess of bacterial growth which releases toxins that attach the lining of the intestines, which causes colitis. It is the bacterium in relationship to the bacteria that causes tetanus and botulism. The bacteria of Clostridum difficile can be found in numerous places, the most common places are in hospitals and health care facilities. The spores of the bacteria are mostly passes through feces and then passed on via food or other contaminated surfaces. There is an active and inactive form. The active can’t survive in the environment of excessive periods of time, while the inactive can live in the environment for excessive periods of time. It is one of the many causes of diarrhea