C.diff Diarrhoea Flashcards
what is the main pathogen causiing Antibiotic associated diarrhoea?
C.Difficile (it produces enterotoxin and cytotoxin)
sy sx of c diff
foul smelling diarrhoea, preceeding infection
rf of c diff
PPI, prolongued NG tube, prolongued hospital of nursing home stay, age, enemas, overuse of broadspectrum abx.
what is a complication of c diff?
pseudomembranous colitis
Ix
- Sigmoidoscopy of value (underused)
* Stool culture and toxin detection (upto 33% false negative)
Tx C.difficile with…
metronidazole/ oral vancomycin/ Fidaxomicin (new and expensive)
fluids, Stool transplantsa dn repeated stool cultures. Patient isolation too.
surgery may also be required.
steps for c.difficle prevention and control in hospitals
reduction and control in prescribing the 4 C’s of antibiotics and broad range antibiotics, antimicrobial management team, isolation, hand washing, cleaning the environment, Infection control nurses.
what are the 4 C’s abx?
cephalosporins, co-amoxiclav, clindamycin, ciprofloxacin
outline the Giardia duodenalis intestinal parasite infection…
present in surface water, asymptomatic cyst carriers, seen on microscopy, treatment by metronidazole, tinidazole
outline the Cryptosporidium parvum intestinal parasite infection…
Water-borne outbreaks, 3-6% of diarrhoea in developed countries, Cattle the principal reservoir, Self-limiting, but often protracted illness, in non-compromised patients.
outline the Entamoeba histolytica intestinal parasite infection…
Microscopy only 50% sensitive - shows hot stool, May mimic ulcerative colitis, Treat symptomatic disease with 10/7 metronidazole and furamide for cyst carriage (asympto-matic disease), causes liver abcesses.
outline Rota virus as a cause of viral gastroenteritis…
> 800,000 deaths in children under 5y, Faecal-oral transmission, Infects mature enterocytes of villous body and tip (not crypts) with cell death and lactose intolerance.
