Sketchy Micro: Clostridium Difficile

Question 1

Like all Clostridia, C. difficile is ____________.

Answer 1

spore-forming

Think of the walnuts on the factory line.

Question 2

What antibiotics are commonly implicated in nosocomial C. difficile diarrhea?

Answer 2

Clindamycin (the “CLeaN” sign above the chocolate pot)

Question 3

C. difficile has two exotoxins: A and B. What does each do?

Answer 3

A: attacks the brush border enzyme of the small intestine, leading to watery diarrhea (think of the girl BRUSHing chocolate onto the apples – A for apple)

B: depolymerizes actin, leading to enterocyte death and necrosis; this results in the pseudomembrane (B is for Black licorice, which is being chewed by the little kid and wrapped in the MEMBRANE by the employee)

Question 4

What is tested for in the stool of someone with suspected C. difficile?

Answer 4

The toxin, because you need to know if the C. difficile is a toxic strain

(think of the worker pulling the toxic shoe out of the diarrhea)

Question 5

What category of bacteria is C. difficile?

Answer 5

Gram-positive (think of the Gram-positive violet that all the workers are wearing) and obligate anaerobe (because all of the workers are wearing gas masks)

Question 6

True or false: IV vancomycin is the best treatment for C. difficile.

Answer 6

False. It has to be oral!

Think of the open van doors with the tongue rolling out.

Question 7

Other than oral vancomycin, _________ can also be used to treat C. difficile.

Answer 7

Metronidazole (think of the metro riding above the factory)