c.diff

Question 1

c.diff microbiology

Answer 1

anaerobic gram positive rod
- spore forming, exotocin producing bacillus
- produces exotoxin which causes intestinal damage -> pseudomembranous colitis

Question 2

causes of C.diff

Answer 2

clindamycin
cephalosporins (ceftriaxone)
co-amoxiclav
ciprofloxacin

PPIs

Question 3

how is c.diff transmitted

Answer 3

faecal-oral by ingestion of spores

Question 4

c.diff features

Answer 4

diarrhoea
abdo pain
raised WCC - v characteristic !

if severe -> toxic megacolon may develop

Question 5

diagnosing c.diff

Answer 5

detecting c.diff toxin in the stool

–> antigen positivity only show exposure to bacteria, ** NOT current exposure**

Question 6

management of c.diff

Answer 6

1st = oral vancomycin for 10days

2nd = oral fidaxomicin
3rd = oral vanc +/- IV metronidazole

life threatening = oral vanc AND IV met

Question 7

management of recurrent c.diff

Answer 7

within 12weeks of sx resolution = oral fidaxomicin

AFTER 12weeks = oral vanc OR fidaxomicin

Question 8

preventing spread of c.diff in hospital

Answer 8

isolation in side room - stay there until no more diarrhoea

all staff wear disposable gloves + apron
hand washing !
- alcohol does NOT kill spores of c.diff