C. diff - Block 2 Flashcards
Describe chracterisitcs of c diff?
Spore forming, toxin producing, G+ anaerobic bacteria
Colonizes in the colon -> ABX associated diarrhea and colitis
Transmission: fecal oral
Describe the pathology of C diff?
- Spores live on surface
- Spores are ingested and lays dormant in intestines
- Disruption of normal flora
- C diff produces toxins A and B -> damage to colon -> inflammation/tissue damage -> diarrhea
Ways you can prevent C diff?
- Soap and water handwashing
- Alcohol based hand sanitizers is NOT effective against spores
What are the precautions taken when encountering Cdiff?
- Clean hands with soap and water
- Wear gloves
- Wear gown
What common RF for C diff infection?
- ABX use
- Age
- Hospitalization and length of stay
- PPI
- Immunocompromised
- IBD
- GI surgery
What are the most common ABX that cause C diff?
3rd and 4th gen cephalosporins
Any ABX has a risk killing good bacteria
Sx of C diff?
- Diarrhea (soft and unformed, strong odor, 20+ movements)
- Ab pain
- N/V
Signs of C diff?
Leukocytosis >15000
Fever
Complications of C diff?
- Dehydration and electrolyte disturbances
- Pseudomembranous colitis
- Toxic megacolon
- Bowel perforation
- Death in 30 days
Diagnostic elements of target CDI population?
- Unexplained
- New onset
- ≥3 unformed stools in 24 hrs
What are the diagnostic lab assays of C diff?
- GDH antigen
- Toxins A and B
- NAAT
What are the tx goals for C diff?
- Alleviate GI sx
- Avoid complications from infection
- Minimize transmission
What are the non pharm recommendatiosn for c diff?
- Hand hygiene
- Use of gloves and gowns
- Isolation
- Contact precautions
- Avoid antidiarrheal agents and PPIs
- Antibiotic stewardship
Usage of probiotics for C diff tx?
Some reduction but insufficient data to use as a recommendation
Tx used for C diff?
Fidaxomicin
Vancomycin
Metronidazole
Rifaximin
Benzlotoxumab