C diff Flashcards
what is C diff
a type of spore forming anaerobic bacteria, present in the bowel of 3% of healthy adults and 20% of hospitalised
T/F: some people carry c diff in the gut asymptomatically
true (asymptomatic colonisation)
when does c diff cause problems (c diff infection)
some Abx/ enteral feeds interfere with balance of normal bacteria in the bowel
> C diff multiplies, produces toxins, causes diarrhoea
Abx most frequently associated with CDI?
4 Cs
- clindamycin
- cephalosporins
- ciprofloxacin
- co-amoxiclav
main risk factor for developing CDI?
previous Abx exposure
T/F: C diff is the most common bacterial cause of healthcare associated GI infection in adults
True
risk factors for C diff infection?
- current/ recent (3/12) use of Abx
- increased age
- prolonged hospital stay
- serious underlying disease
- surgical procedure
- immunosuppression
- use of PPIs
symptoms of CDI
1) usually occur when in relation to Abx treatment?
2) can occur up to __ __ after discontinuation
1) between day 4-9 of treatment
2) 8 weeks
T/F: CDI is not always ass with diarrhoea
true (most common symptom though)
symptoms of CDI?
Mainly diarrhoea
Also abdo cramps, fever, stool frequency, raised WCC
What is diarrhoea defined as?
passage of 3 or more loose/ liquid stools per day or more than the normal for that individual
how does C diff spread
Faecal-oral
symptomatic CDI patients shed pores via their stool > patient/ surfaces around the toilets/ commodes are touched > spores are ingested
steps in the chain of infection?
1) infectious agent
2) reservoir (the bowel)
3) portal of exit (diarrhoea)
4) mode of transmission (faecal-oral)
5) portal of entry (oral > GIT)
6) susceptible host (infants, elderly, immunosuppressed, recent Abx)
treatment of CDI?
as soon as suspected start oral metronidazole (oral vancomycin if severe)
how to stop the spread of CDI?
1) Isolate pt
2) review their Abx
3) use PPE
4) decontaminate environment and equipment
5) hand hygiene
