Why Should We Use Metronidazole For Clostridium Difficile Infection?

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.

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, a nosocomial pathogen, is of critical importance. By 2010 it was the most prevalent healthcare-related pathogen globally [1], accounting for 20-30% of antibiotic-associated diarrheal cases in healthcare settings [2]. Symptoms of C. difficile infection (CDI) are significant and include severe diarrhea and dehydration. In more serious cases, CDI can result in pseudomembranous colitis, bowel perforation, sepsis and even death [3, 4].Beyond serious impact upon patients, CDI is costing multiple billions of dollars in hospital care in the United States alone [5]. Clearly the need exists to identify and characterize the infection and toxicity pathways of C. difficile.

CDI cannot be treated with many antibiotics, and as early as 2000 another strain appeared that was resistant to even more antibiotics, including fluoroquinolones (“Antibiotic/Antimicrobial Resistance.”). This new strain creates more toxins and can show up in people not normally considered at risk for CDI infection, like those who have not been hospitalized or treated with antibiotics (“C. difficile infection.”). This aggressive strain only adds more danger to an already resistant bacteria. As antibiotics became more common, they were prescribed for thousands of common illnesses. Over time, Clostridium difficile has built up a resistance to antibiotics to become a major concern. Even more frightening, it has started to appear in the community. In fact, the Centers for Disease Control rate it as an urgent threat. Superbugs like CDI are becoming a more ever-present threat and we must continually work towards newer and more effective treatments to counteract the bacterias frightening ability to resist us (“Antibiotic/Antimicrobial Resistance.”). CDI is just one of many superbugs, however, and others pose just as great a

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.

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.

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).

Clostridim difficile was first isolated in1935 by George and his colleagues from a stool found in a healthy infant by the name of Hall and O’Toole (Heinlen and Ballard, 2010). Yet in 1978, C.difficile was known to be associated as disease in human’s antibiotic-associated diarrhea (Heinlen and Ballard, 2010). It is 2 types of C. difficile: one that exists in spore form and the other in vegetative form. Depending on the type of form it exist in, allows it to grow in a certain environment. It is also a gram positive rod bacterium. When Clostridim difficile exist in a spore form, it can live in harsh conditions and in common sterilization techniques (Heinlen and Ballard, 2010). When C. difficile exist in spore form, it will be resistant to temperature

The purpose of this paper is to develop a summary that you could use within an evidence-based practice (EBP) committee or related venue to share with your colleagues. In this case, this summary will be focused on guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections (Surawicz et al., 2013). This paper will discuss the scope and purpose of the clinical practice guideline, examine stakeholder involvement, review rigor of development, analyze recommendations for practice, and concluding with implementation of clinical practice guidelines regarding the issue of infection

Clostridium difficile is a very common nosocomial infection. There are two particular recent incidents that have been recorded and taken advantage of in order to see what the nosocomial disease is capable of. One case in particular occured in China back in the span years of 2014 and 2015. This case involved separating different strains found throughout the hospital to in order to examine virulence ability. C. difficile was monitored due to the fact that it is able to produce spores that are resistant to regular control measures. This case in china occurred due to the fact transmission ability and susceptibility of this bacterium is not often assessed in this country (6).

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).