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Infection Diseases > Clostridioides Difficile Infection > Flashcards

Clostridioides Difficile Infection Flashcards

1
Q

Gram stain of Clostridioides difficile

A

Gram positive bacillus
Anaerobic
Spore forming

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2
Q

Why does use of some antibiotic increase susceptibility to Clostridioides difficile infection?

A
  • They alter + supress healthy normal intestinal micro flora competing for space
  • Allows proliferation of Clostridioides difficle + toxin production
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3
Q

What antibiotic is are associated with increased susceptibility to Clostridioides difficile colitis?

A

Amoxicillin
Clindamycin
Cephalosporins
Fluoroquinoloes

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4
Q

What does a Clostridioides difficle infection cause?

A

Antibiotic associated diarrhoea + colitis

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5
Q

What can inhibit the growth of Clostridioides difficile?
Why?

A

Oxygen
C. Difficile is a anaerobic bacteria

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6
Q

Transmission of Clostridioides difficile

A

Spore transmission
Spore forming bacteria

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7
Q

Why can Clostridioides difficle survive for a long time?

A

Spore forming bacteria
Spores are resistant to heat, acid + antibiotics

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8
Q

Why does good hand hygiene + regular glove use disruption Clostridioides difficile transmission?

A

Spores can be transferred to patients via hands of healthcare personnel
Reduces spread

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9
Q

What is the main protective barrier against Clostridioides difficle?

A

Normal intestinal micro flora

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10
Q

What types of toxins does Clostridioides difficle produce?

A

A+B

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11
Q

What type of toxin is toxin A from Clostridioides difficle?

A

Enterotoxin

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12
Q

What type of toxin is toxin B from Clostridioides difficle?

A

Cytotoxin

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13
Q

What does toxin A from Clostridioides difficle do?

A

Causes excessive fluid secretion&raquo_space; diarrhoea
Stimulates an inflammatory response&raquo_space; colitis
Has some effect of damaging cell structure

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14
Q

What does toxin B from Clostridioides difficle do?

A

Damages protein synthesis + cell structure

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15
Q

Risk factors associated with Clostridioides difficle infection

A

Antibiotic exposure
Older age
Hospitalisation
Immune suppression
Inflammatory bowel disease

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16
Q

When should a diagnosis of Clostridioides difficile colitis be suspected?

A
  • Any patient with diarrhoea
  • Received antibiotics in previous 3 months
  • Recent hospitalisation and/or diarrhoea within 48 hours after hospitalisation
17
Q

What are the stages of Clostridioides difficile infection?

A

Asymptomatic
Mild-moderate
Severe
Severe/complicated

18
Q

Signs and symptoms of mild or moderate Clostridioides difficile infection

A

Diarrhoea
Presence of mucus of blood in stool
Fever
Abdominal cramping

19
Q

Signs and symptoms of severe Clostridioides difficile infection

A

Leukocytosis
Elevated serum creatinine levels
Pseuedomembranous colitis
Diarrhoea

20
Q

Signs and symptoms of severe, complicated Clostridioides difficile infection

A

Ileus - loss of bowel motility
Hypotension
Shock
Sepsis
Abdominal perforation
Diarrhoea

21
Q

What tests are done on stool samples?

A

Enzyme immunoassay (EIA)
PCR

22
Q

What are EIAs used for in diagnosis of Clostridioides difficle infection?

A

Glutamate dehydrogenase produced by C.difficile
Detecting toxins A + B

23
Q

What are PCR assay used for in diagnosis of Clostridioides difficle infection?

A

Toxin gene

24
Q

What is the aim of tests for Clostridioides difficile?

A

Identify C.difficile bacteria
Presence of toxin

25
Q

Treatment of Clostridioides difficile infection

A

Varies dependent on severity
Mild - oral or IV metronidazole
- oral vancomyocin 10 day
Severe - vancomyosin

26
Q

Treatment of mild Clostridioides difficile infection without fever, abdominal pain or leucocytosis

A

Cessation of antibiotics

27
Q

Treatment of mild-moderate Clostridioides difficile infection

A

Oral or IV metronidazole
Oral vancomycin

28
Q

Treatment of severe, complicated Clostridioides difficile infection

A

vancomycin

29
Q

Why is vancomycin used to treat of mild severe, complicated Clostridioides difficile infection over metronidazole?

A

Produces faster symptom resolution
Fever treatment failures

30
Q

Treatment for relapse infection of Clostridioides difficile

A

Investigational therapies
Faecal microbiota transplantation to repopulate gut flora

31
Q

Prevention of Clostridioides difficile infection

A

Careful use of antimicrobial agents - educate
Emphasise importance of hand washing
Isolate if CDI suspected
Wear PPE when visiting CDI patients
Clean surfaces

32
Q

Why is hand washing better at preventing Clostridioides difficile infection than hand gel?

A

Alcohol does not kill C.difficile spores

33
Q

Drugs used against Clostridioides difficile infection

A

Vancomycin - serious
Metronidazole - mild
Fidaxomicin

34
Q

What is faecal microbiota transplantation?

A

Transfer of stool from healthy donor to patient with CDI to reconstitute normal gut microbial flora

35
Q

Risk of faecal microbiota translpantation

A

Transmission of HIV, hepatitis + retrovirus

36
Q

Virulence factor of Clostridioides difficile

A

Enterotoxin A
Cytotoxin B

Infection Diseases (22 decks)

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