Metronidazole Infection: A Case Study

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.

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?

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

Ample literature has been published to elucidate the pervasive nature of Clostridium difficile and its relationship with inadequate health-care practices. Clostridium difficile-associated disease: New challenges from an established pathogen by Sunshine and McDonald, published in the Cleveland Clinic Journal of Medicine discusses the concern over Clostridium difficile. It includes a case report involving infection caused by the bacterium and important guidelines for prevention and treatment associated with the bacterium.

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

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.

Treatment begins with taking an antibiotic and stop taking the antibiotic that is causing the bacterium. The antibiotics will suppress normal colonic bacteria that will keep C. diff from causing colitis. The most common antibiotics are vancomycin and metronidazole. Both drugs prevent bacteria from forming the cell wall. Another drug fidaxomicin an oral antibiotic is used for severe cases but cost more than the other two drugs, it has the same effect as vancomycin. Mild to moderate infections are usually given metronidazole with side effects including nausea. Severe infections are usually given vancomycin or fidaxomicin with side effects including abdominal pain and nausea. The option for surgery is available for severe cases removing the diseased section of the

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 now considered to be one the most important causes of health care-associated infections. C. diff infections are also emerging in the community and in animals used for food, and are no longer viewed simply as unpleasant complications that follow antibiotic therapy. Since 2001, the prevalence and severity of C. diff infection has increased significantly, which has led to research on C. diff. This research summarizes C. diff background, causes, symptoms, infection occurs, diagnosis, treatment, and prevention. This will give the reader some type of aspect about C.diff.

Most of the public have heard of broad-spectrum drugs, especially in terms of antibiotic resistance, because they fight a wide range of bacteria but also kills normal flora in the gut (Haddox, 2013). The loss of this gut flora can lead to an abnormal growth of harmful bacteria such as clostridium difficile (C-Diff). The four “C” antibiotics that have a high risk for patient to develop C-diff are clindamycin, cephalosporins, coamoxiclav, and ciprofloxacin (Haddox, 2013). These antibiotics have the highest risk of leading to C-diff development, however all antibiotics increase a patient’s likelihood of a C-diff infection. This effect can last up to 12 weeks post antibiotic administration (Haddox, 2013).