C.diff Flashcards

1
Q

c. diff classification

A

GP spore forming anaerobe

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2
Q

what exotoxins do c. deff produce

A

Toxin A and thin B
PCR detects B

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3
Q

symptoms

A

water diarrhea, abdominal pain, nausea, leukocytosis, fever

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4
Q

severe disease can lead to

A

pseudomembranous colitis and death

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5
Q

risk factors

A

prolong hospitalization or healthcare exposure
antibiotic exposure
gastric acid suppression (PPI/H2r antagonist)
immunosuppression (chemo/hiv)
advanced age
female

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6
Q

what antibiotics are high risk
(broad)

A

3rd/4th gen cephalosporins
clindamycin
fluroquinolones
carbapenems

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7
Q

moderate risk antibiotics

A

broad spectrum penicillins
1st-2nd gen cephalosporin
TMX/SMX
macrolides

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8
Q

low risk abx

A

aminogycosides
tetracycline
pencilins
chloramphenicol
daptomycin
tigecycline

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9
Q

elevated gastric pH allows

A

c.diff spores to germinate into vegetation toxigenic cells

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10
Q

diagnosis

A

> =3 unformed stool in 24 hr + positive toxin test

multi step testing preferred
-GDH + toxin A/B assay
-NAAT (PCR) + toxin A/B assay (common)

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11
Q

mild or moderate or severe treatment

A

fidaxomicin 200mg (Preferred) x 10 days

or vancomycin 125 mg ( alternative) x 10 days

if both not available: metronidazole 500mg x 10-14 days

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12
Q

fulminant treatment
(hypertension or shock, ileus, megacolon)

A

vancomycin 500mg + Metronidazole 500mg

10-14 days

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13
Q

is routine combination of metronidazole and vancomycin is

A

not recommended

ONLY for fuminant c.dif episodes

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14
Q

bezlotoxumab

A

reduce recurrence of CDI in pt > 18 who RE RECIEVING antibacterial risk drug treatment and high risk or recurrence

human IgGI monoclonal
1/2 life = 19 days

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15
Q

what methods are highly likely of restoring normal microbiota to reduce recurrent CDI

A

fecal transplant or SER 109

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16
Q
A