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You will prepare and submit a term paper on C-Difficile. Your paper should be a minimum of 750 words in length.
You will prepare and submit a term paper on C-Difficile. Your paper should be a minimum of 750 words in length. Moreover, outbreaks of C. difficile infection in Canada and U.S.A. have been linked with the highly resistant and virulent strain of the bacterium, NAP-I/027 and have been found resistant to the fluoroquinolones drug treatment (Allday 2012 para 3. Aktories & Wilkins 2000 p. 1 & 2. Talley et al 2010 n.p.). The microbiology of C. difficile, the pathophysiology of infection in humans, clinical presentation, risk factors, diagnostic strategies and preventive measures will be discussed.
The microbiological study of C. difficile has brought forward some significant features about the bacterium. It is an anaerobic bacterium which means that it requires oxygen for its survival and spore-bearing. It stains mostly Gram-positive and has a length variation of 3-5 um. Animal reservoirs for C. difficile have been located but no direct association with human infection has been established. C. difficile spreads in the infants and neonates predominantly by nosocomial infection rather than vertical transmission. An important aspect is that infants up to the age of 12 months are protected from the diarrheal symptoms, probably because they lack the receptors required for the toxin action. The bacteria spread mostly from contact with contaminated skin, food items, clothes or any other surface. C. difficile spreads from the feces of an infected person to the healthy individuals. (Aktories & Wilkins 2000 p. 2-5. Allday 2012 para 12). The spores produced by the bacteria are orally ingested by the humans leading to the formation of C. difficile colonies in the gut. The infected individuals develop Clostridium difficile associated diarrhea while some also remain asymptomatic and show no active infection. C. difficile produces two exotoxins- A and B- which cause disruption of the epithelium of the colon by binding to the epithelial cells. The production of inflammatory cells and cytokines leads to mucosal inflammation and small ulcer formation in the gut (Talley et al 2010 n.p.). The clinical features of the C. difficile infection are described as watery, non-bloody diarrhea and episodes of abdominal pain. Severe infections can lead to development of ileus and even shock. Non-specific signs include low-grade fever, dehydration and abdominal tenderness. A criterion to describe the severity of the infection involves the parameters of age, temperature, albumin level, WBC count, endoscopy findings and treatment in intensive care unit. A score of greater than or equal to 2 within 48 hours is designated as severe Clostridium difficile associated diarrhea (Talley et al 2010 n.p.). The risk factors for C. difficile infection mainly focus on the elderly population, people taking antibiotic or antacid therapy or those with a prolonged stay in hospital environments. According to a report, recurrence was found to be higher in those who were taking medications that were H2 receptor blockers (Worcester 2012 para 1- 3). People above the age of 65 years are at high risk for severe or complicated infection. Other risk factors include tube feeding within 2 months, immunosuppression and excessive usage of broad-spectrum antibiotics (Talley et al 2010 n.p.). Enzyme immunoassay is the standard test for the diagnosis of the C. difficile toxins A and B in the stool samples. The test results are available within 24 hours.
