(VIII)Sporing Anaerobic Gram Positive Rods (1)*Clostridiodes difficile

Question 1

Name 2 common predisposing factors to developing C. diff

Answer 1

(1) Clindamycin
(2) Poor handwashing

(⇒ Diarrhea)

Question 2

Clostridium difficile infection

Found in: […]

Virulence factor: […]

Clinical presentation
[…]

Diagnosis:
[…]

Treatment:
[…]

Answer 2

Clostridium difficile infection

Found in: Faeces of minority of population

Virulence factor: Exotoxin, A and B

Clinical presentation

• Pseudomembranous Colitis (PMC) usually precipitated by wide spectrum antibiotic use (esp clindamycin, ampicillin(due to low absorption), cipro), disturbing balance of normal gut flora
• Can lead to toxic megacolon
• C. difficile associated diarrhoea **(CDAD)

Diagnosis:
Feaces sample
- Must detect toxin via PCR/ELISA
- Can detect organism via GDH antigen ELISA/culture

Treatment:
ORAL Vancomycin/Metronidazole
- stop antibiotics if possible
- Isolate patient, enhanced cleaning, laundry, hand hygiene
- For the adventurous…..faecal transplant lol….

IV vancomycin is absolutely worthless here (doesnt even get to the GIT). Please do not even suggest. IV metronidazole can get to GIT so it is still ok.

“Vancomycin is unique in that it is not absorbed when taken orally and therefore remains in the gastrointestinal tract at the site of infection. Think of the Vancomycin “Van” cruising down the gastrointestinal tract to run over hapless Clostridium difficile bacteria.”