CLOSTRIDIUM Flashcards
What kind of pathogen is Clostridium?
Bacteria
Is Clostridium gram positive or gram negative?
Gram positive
What would Clostridium look like on a microscope slide?
Purple bacillus (rods)
Does Clostridium require oxygen?
No, it’s anaerobic
What are the different strains of Clostridium?
C. Tetani
C. Botulinum
C. difficile
C perfringens
C. septicum
C. sordelli
Where does C. tetani originate?
Soil and feces, it is an obligate anaerobe (grows and survives only in absence of O2)
How does C. tetani infect the host?
-Toxin mediated, will enter through wounds and travels through the bloodstream/nerves to the CNS
*Rare in the US <100
Can infect:
-Umbilical stump
-Soft tissue injury
-Secondary infection from IV drug use
-Burns
-Septic abortions
What kind of symptoms are present in a C.tetani infection?
***Tetanus: lockjaw, facial contractions (these progressive neuro symptoms are treatable and preventable)
-Symptoms will present usually 1 week after injury
-Death can occur from autonomic NS instability/respiratory failure
How can C. tetani be treated?
-Prevention/Vaccination (tetanus shot every 10 years!)
-Administer Tetanus immune globulin (for antibodies)
-Metronidazole for soft tissue infection
-Debridement of wound if necessary
How can C.botulinum infect a host?
-Improperly canned foods
-Spores in honey (infant ingestion)
-Entry through wounds
-Inhalation
-Iatrogenic (provider can transmit to patients if they don’t take precautions with other C. botulinum + patients)
What do the bacilli of C.botulinum and C. difficile form?
Spores
What is the pathogenesis of C. botulinum?
Toxin mediated
*uncommon in U.S. <200
What is the presentation of C. botulinum?
***Botulism
4 D’s
Dysphagia (difficulty swallowing)
Dysarthria (difficulty speaking)
Diplopia (double vision)
Descending paralysis
-Hyproflexia (absent reflexes)
-Symmetrical paresis (partial paralysis)
-Afebrile (not feverish)
-Ptosis (eyelid drooping)
How can you diagnose C.botulinum/Botulism?
Detect the Botulinum toxin in food, vomit, blood
How can C. botulinum/Botulism be treated?
-Anti-toxin
-Respiratory support (if not treated quickly, can cause death)
-GI decontamination if food borne/necessary
Will colonization of C. difficile always result in disease?
No, it can colonize without causing infection
What is the pathogenesis of C. difficile?
-Toxin mediated
Risks for infection: Antibiotic use after an exposure (can wipe out normal gut flora and promote further colonization/infection of C.diff)
***Most common causes: Clindamycin, Quinolones
*Can be caused by PPI’s (proton pump inhibitors/essentially antacids) because they decrease stomach acid production preventing the killing of C. diff when it enters the GI tract
Who is most susceptible to C.diff infection?
-People over 65
-Immunocompromised patients
*Most common cause of nosocomial (hospital acquired) diarrhea
How does a C. diff infection present?
-Colitis (inflammation of inner colon)
-Toxic megacolon (swelling and inflammation spreading to deeper layers of the colon)
-Sepsis
-Death
How can you diagnose a C. diff infection?
-PCR for organisms AND confirm toxin PCR
How can you treat C. diff?
-Oral/rectal Vancomycin or Fidaxomicin ($$$)
-Oral Metronidazole (not first line)
For severe infection or if oral route not an option: IV metronidazole
Solid stool: No treatment!
What can lead to Infection of C. perfringens, septicum, and sordelli?
-Trauma or septic abortions
What kind of anaerobes are C. perfringens, septicum, and sordelli?
Obligate (survive only in the absence of O2)
What is the pathogensis of C. perfringens, septicum, and sordelli?
Gas formation in tissues (Gas gangrene) which causes tissue damage
How would a C. perfringens, septicum, and sordelli infection present?
Rapid progression of fever, pain, shock, may cause death
-Hemolytic anemia (red blood cells destroyed faster than they are made)
-Renal failure
-DIC (abnormal blood clotting)
How can a C. perfringens, septicum, and sordelli infection be treated?
-Surgery
-Clindamycin and Penicillin
