C.diff Flashcards
C.diff spread?
Clostridioides difficile: spreads via the faecal-oral route by ingestion of spores
What increases the chance of getting c.diff?
Clindamycin - before
2nd and 3rd gen cephalosporins
PPI!!!
What are the toxins produced by cdiff?
releases two exotoxins (toxin A and toxin B) that act on intestinal epithelial cells and inflammatory cells resulting in colitis
What is the bacteria type for c diff ?
Gram positive Rod
Blood market feature is cdiff
Raised WBC!
Complication of cdiff ?
Toxic mega colon
Diagnosis of cdiff
is made by detecting C. difficile toxin (CDT) in the stool
C. difficile antigen positivity only shows exposure to the bacteria, rather than current infection
First episode of C. difficile infection
first-line therapy is ?
oral vancomycin for 10 days
second-line therapy: oral fidaxomicin
third-line therapy: oral vancomycin +/- IV metronidazole
Recurrent episode ?
within 12 weeks of symptom resolution: oral fidaxomicin
after 12 weeks of symptom resolution: oral vancomycin OR fidaxomicin
Life-threatening C. difficile infection?
oral vancomycin AND IV metronidazole
specialist advice - surgery may be considered
Specific target toxin therapy for cdiff ?
bezlotoxumab is a monoclonal antibody which targets C. difficile toxin B
If a patient had two or more episodes of cdiff what can be considered?
faecal microbiota transplant
may be considered for patients who’ve had 2 or more previous episodes
Complication of cdiff?
if severe toxic megacolon may develop
