The Microbiology Of Clostridium Difficile

Clostridium difficile infection or CDI is a disease that is caused from a severe mishap of the microbiota in the gut by antibiotics. This causes the patient to have persistent diarrheal problems from mild symptoms to very extreme and severe symptoms. In the past twenty years, this infection has been on the rise in numbers of problems in public health and has even caused a number of deaths. Although this is not the only infection the transplant can help conquer, C.difficile a great example to portray since in the past ten years it has become a growing health problem.

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

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?

The healthcare professional can expect to encounter various conditions within their scope of experience. Clostridium difficile represents one of the most common and challenging nosocomial infections that can cause life-threatening complications such as hypervolemia, sepsis, pain, and peritonitis (Grossman and Mager 155). The recognition, diagnosis, treatment and inhibition of transmission of this bacterium are imperative in order to limit infection and prevent death.

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 spore-forming and strict anaerobe gram-positive bacillus [4], capable of excreting pathogenic toxins, as discussed below [3]. This spore forming ability is a method of bacterial persistence within the human body. C. difficile is able to resist and survive a variable environment when various other microbes cannot. Three important factors affecting the risk of CDI include the use of antibiotics, length of hospital-environment exposure and age [1]. The use of broad range antibiotics affects the composition and lively-hood of normal

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

This article, which was submitted for review in 2013, was written by Lennard YW Lee, Ramez Golmohamad, and George MacFaul of the Department of Gastroenterology, Milton Keynes NHS Foundation Trust, Standing Way, Milton Keynes MK65LD, United Kingdom. The paper was accepted for publication August 25, 2013.

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).