Clostridium difficile

Question 1

Another name associated with C. diff

Answer 1

pseudomembranous colitis

Question 2

Clinical presentation of C.diff

Answer 2

• begins 4 to 10days after broad spectrum oral antibiotic therapy, esp. with beta lactams and clindamycin
• usually nosocomial inf.
• associated with excessive use of PPIs
• early symptom is watery diarrhea
• leukocytes and other cells penetrate the connective tissue
• formation of a grey, white, or yellow exudate, pseudomembrane

Question 3

Description of CDAD(C. diff associated diarrhea)

Answer 3

• requires both disruption of native flora and presence of C.diff
• ingestion of spores without dysbiosis leads to asymptomatic carriage

Question 4

Read slides for

Answer 4

-presentation of a case study and images

Question 5

Epidemiology of C. diff

Answer 5

• C.diff part of normal flora, but at low level
• antibiotics or PPIs that disrupt normal flora allow C.diff to grow
• diarrhea disseminates C. diff
• acquired in health care setting

Question 6

Pathogenesis of C.diff

Answer 6

• enterotoxin; toxin A; fluid accumulation

- cytotoxin; toxin B; kills gut epithelial cells

Question 7

Control of C.diff

Answer 7

• stop previous antibiotic if feasible and replenish gut flora
• fecal transplant from healthy donor
• vancomycin, metronidazole to kill C.diff
• Fidaxomycin for recurrent C.diff associated diarrhea
• fluid replacement