seminar 1- c.diff

Question 1

what is c.diff?

Answer 1

gram positive, spore forming, anaerobic bacteria

Question 2

what causes a c.diff infection?

Answer 2

usually preceded by antibiotic use that kills off normal gut flora, ingestion of spores via fecal oral route

Question 3

symptoms and complications of c.diff

Answer 3

abdominal discomfort, nausea, fever, diarrhea (>three watery stools in 24h), toxic megacolon, pseudomembranous colitis, colon perforation, sepsis and death

Question 4

how are c.diff infections confirmed?

Answer 4

• GDH EIA, toxin A and B EIA/PCR and cell culture cytotoxicity assay
• tests range in sensitivity and ability to detect toxigenic c.diff
• WBC count and serum creatinine can determine infection severity

Question 5

who is at risk of c.diff?

Answer 5

older adults, taking antibiotics, GI surgery, serious/chronic illness, prolonged hospitalization, immunosuppression, chronic acid reflux medication use

Question 6

how does c.diff spread?

Answer 6

on hands of HCW and objects

Question 7

how is c.diff treated?

Answer 7

stopping the antibiotic course and starting vancomycin (PO), fluid and electrolytes, fecal transplant for severe cases

Question 8

how does vancomycin MOA differ from other beta lactam antibiotics?

Answer 8

• vancomycin binds to cell wall precursors (preventing cross-linking)
• other beta lactams inhibit transpeptidases/activate autolysins, disrupting cell wall formation