C.Difficile Nathwani and orange Flashcards
C diff is an _____ gram-___ ____ ____ ____ . There are very few of these
Anaerobic gram-positive
spore forming bacillus.
CDI is associated with ______ colitis
pseudomembranous
Today, CDI is known as the major cause of ____ and ____ in patients exposed to antibiotics.
Today, known as the major cause of diarrhoea and colitis in patients exposed to antibiotics.
more common in ___ than ___ ___
colon, small intestine
what are the key risk factors for getting it?
- Age ≥ 65 year
- Immunosuppression
- PPI use ≥ 3-fold
- Hospitalization, long-term care facilities
- Previous CDI
- ANTIBIOTIC USE
- low serum antibody response to toxin A
what are the 4C antibiotics that should be reduced to prevent CDI?
CEPHALOSPROINS,
CLINDAMYCIN,
CIPROFLOXACIN [QUINOLONES]
CO-AMOXICLAV,
CLARITHROMYCIN [MACROLIDES]
patients should get their own ___, should use __ and __ for contact with CDI patient, use ___ and _____ for washing hands and not -____ __
private room, gown and gloves, soap and water, alcohol gel
Apart from complications __-__% will get reccurrence
Once have second episode have ___ -____% chance of recurrence
Apart from complications 20-30% will get reccurrence
50-60%
Timing of relapse can be ___ to ____/___- after the first infection
Timing of relapse can be days to weeks/months after the first infection
______ will be used locally for 1st relapse within 12 weeks ONLY on say of microbiology or infectious diseases
Fidaxomicin will be used locally for 1st relapse within 12 weeks ONLY on say of microbiology or infectious diseases
what is the new treatment therapy for CDI?
Duodenal infusion of donor feces after vancomycin for 4 days and bowel lavage
what are the drivers for C>DIFF infection ?
IMPORTANT - LEARN THIS FOR EXAM
A. BROAD SPECTRUM ANTBIOTIC THERAPY
B. SPECIFIC ANTIBIOTIC TYPES E.G CEPHALOSPORINS
C. LONG DURATION OF THERAPY
D. VULENRABLE POPULATION E.G ELDERLY, NURSING HOME, CO-MORBIDITIES, HOSPITALISED
E. ROUTE OF THERAPY MAKES NO DIFFERENCE
F. TOTAL AMOUNT OF ANTIBIOTIC USE – number of exposures
G. GIVING ANTIBIOTIC IN THE ABSENCE OF INFECTION
C diff often present in small numbers in bowel. Infection occurs when antibiotics are prescribed that kill off normal competitive bowel flora and allows C diff to overgrow. Organism produces _____ that survive in the environment and are more resistant to ____ and the organism CAN be transmitted from one patient to another.
C diff often present in small numbers in bowel. Infection occurs when antibiotics are prescribed that kill off normal competitive bowel flora and allows C diff to overgrow. Organism produces spores that survive in the environment and are more resistant to disinfectants and the organism CAN be transmitted from one patient to another.
how does c.diff cause harm
Organism produces 2 toxins; toxin A (enterotoxin) and toxin B (cytotoxin)
the enterotoxin works on the ___
gut
