C. Diff

Question 1

What is clostridium difficile?

Answer 1

Gram +ve bacteria which infects the colon and produces toxins which can cause diarrhoea

Question 2

What factors pre-dispose someone to developing a C diff infection?

Answer 2

>65 yo 
Recent hospital or nursing home stay 
Weakened immune system 
Previous infection 
Feeding tubes 
PPI

Question 3

How C diff diagnosed?

Answer 3

Stool sample taken
-2 stage process with rapid screening test for C diff protein and ELISA for toxins

AXR
-toxic megacolon

Question 4

How can a C diff infection be treated?

Answer 4

Vancomycin or metronidazole or Fidaxomicin

Question 5

How might someone with C diff present?

Answer 5

Raised temp
Colic 
Diarrhoea 
Raised CRP 
Raised WCC
Decreased albumin 
Colitis 
Can progress to toxic megacolon

Question 6

What condition does C diff cause? What is the characteristic features of this disease in the colon?

Answer 6

Pseudomembranous colitis

-yellow plaques on inflamed non-ulcerated mucosa

Question 7

How can you prevent the spread?

Answer 7

Hand washing
Side room isolation
PPE

Question 8

How can you determine when C diff infection has cleared?

Answer 8

No longer symptomatic AND 2 days since last unformed stool
-infected person can still shed bacteria when symptoms have resolved

NOTE:
-patient can remain positive for up to 30 days after symptoms resolved