c difficile

Question 1

what is c difficile

Answer 1

a spore forming bacteria present in the bowel

Question 2

how common is c difficile in healthy people

Answer 2

present in the bowel of up to 3%

Question 3

how common is c difficile in hospitalised people

Answer 3

present in the bowel of 20%

Question 4

describe dormant c difficile

Answer 4

does not need oxygen to survive, can live well in the bowel without causing harm

Question 5

when does c difficile begin to cause harm

Answer 5

if antibiotics interfere with the gut microflora, the c difficile can multiply and produce toxins

Question 6

what is the main illness caused by CDI

Answer 6

diarrhoea

Question 7

what is the main risk factor for acquiring CDI

Answer 7

exposure to antibiotics

Question 8

what are the 4-antimicrobials associated with CDI

Answer 8

• clindamycin
• cephalosporins
• ciprofloxacin
• co-amoxiclav

Question 9

what is coamoxiclav

Answer 9

broad spectrum penicillins

Question 10

how severe is CDI in children

Answer 10

it can be mild or life threatening

Question 11

what does the scottish guidance for testing on c difficile recommend

Answer 11

test patients aged three years and above

Question 12

what is the most common bacterial cause of healthcare associated gastro intestinal infection in adults

Answer 12

CDI

Question 13

how many cases of CDI result in death

Answer 13

5-10%

Question 14

how long can patients infected with CDI be in hospital

Answer 14

1-3 weeks or more

Question 15

what does CDI cause for the NHS

Answer 15

• morbitity
• mortality
• service disruption

Question 16

describe the route of c difficile infection

Answer 16

• patients receive antibiotics or enteral therapy
• this alters microflora in the gut
• patients exposed and can become colonised
• depending on virulence of the microorganism and vulnerability, there is asymptomic colonised or multiplication and release of toxins
• infection

Question 17

what is the criteria that must be met if a person is to become infected with c difficile

Answer 17

• bowel flora must be altered
• blowel flora must be colonised with toxigenic stain
• organism must grow and produce its toxins

Question 18

what are the risk factors for CDI

Answer 18

• use of antibiotics
• increase in age
• prolonged inpatient stay
• underlying diseases
• surgical diseases
• surgical procedures
• immunosuppression

Question 19

what are proton pump inhibitors

Answer 19

drugs which reduce the production of stomach acid

Question 20

what is an example of a proton pump inhibitor

Answer 20

omeprazole

Question 21

how many cases of c difficiile infection occur in those over 65

Answer 21

75%

Question 22

when do symptoms begin once infected with CDI

Answer 22

between day 4 and day 9