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    Clostridoides Difficile

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    yabhas chhetri
    Clostridioides difficile is a gram-positive, spore-forming anaerobic bacterium that can cause C. difficile infection through its toxins A and B. Risk factors include recent antibiotic use, advanced age, gastric acid suppression, recent hospitalization, and immune suppression. Clinical manifestations include watery diarrhea, abdominal pain and tenderness, and symptoms range from mild to severe including pseudomembranous colitis. Diagnosis involves stool testing for C. difficile toxins or glutamate dehydrogenase antigen. Treatment depends on severity and recurrence with options including metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplantation.

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    Clostridoides Difficile

    Uploaded by

    yabhas chhetri
    20 views2 pages
    Clostridioides difficile is a gram-positive, spore-forming anaerobic bacterium that can cause C. difficile infection through its toxins A and B. Risk factors include recent antibiotic use, advanced age, gastric acid suppression, recent hospitalization, and immune suppression. Clinical manifestations include watery diarrhea, abdominal pain and tenderness, and symptoms range from mild to severe including pseudomembranous colitis. Diagnosis involves stool testing for C. difficile toxins or glutamate dehydrogenase antigen. Treatment depends on severity and recurrence with options including metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplantation.

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    A poster on C.difficile

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    Clostridoides difficile

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    Clostridioides difficile is a gram-positive, spore-forming anaerobic bacterium that can cause C. difficile infection through its toxins A and B. Risk factors include recent antibiotic use, advanced age, gastric acid suppression, recent hospitalization, and immune suppression. Clinical manifestations include watery diarrhea, abdominal pain and tenderness, and symptoms range from mild to severe including pseudomembranous colitis. Diagnosis involves stool testing for C. difficile toxins or glutamate dehydrogenase antigen. Treatment depends on severity and recurrence with options including metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplantation.

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    © All Rights Reserved
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    20 views2 pages

    Clostridoides Difficile

    Uploaded by

    yabhas chhetri
    Clostridioides difficile is a gram-positive, spore-forming anaerobic bacterium that can cause C. difficile infection through its toxins A and B. Risk factors include recent antibiotic use, advanced age, gastric acid suppression, recent hospitalization, and immune suppression. Clinical manifestations include watery diarrhea, abdominal pain and tenderness, and symptoms range from mild to severe including pseudomembranous colitis. Diagnosis involves stool testing for C. difficile toxins or glutamate dehydrogenase antigen. Treatment depends on severity and recurrence with options including metronidazole, vancomycin, fidaxomicin, and fecal microbiota transplantation.

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    CLOSTRIDOIDES DIFFICILE clostridoides difficile infection

    Hospital-acquired CDI: hospitalization in preceding 12


    Like all Clostridia , c.difficile are gram positive, obligate anaerobic, spore-forming weeks
    rods Community-acquired CDI: No hospitalisation in the
    .Toxigenic strains cause C. difficile infection preceding 12 weeks
    .Highly contagious Recurrent CDI: recurrence of symptoms and a positive
    .Orofecal route of transmission stool test for CDI (NAAT or EIA) after a confirmed episode
    in the previous 8 weeks

    RISK FACTORS ClINICAL MANIFESTATIONS

    Symptoms typically develop during antibiotic treatment or 2–10 days following its initiation;
    Recent antibiotic
    however, 25–40% of cases manifest as late as 10 weeks following treatment.
    Treatment(Clindamycin,Cephalospor
    ins,Fluoroquinolones,Penicillin)
    ≥
    Watery diarrhea( Foul smelling ) 3 times / day.
    May contain traces of mucus or occult blood.
    Advanced age
    Cramping abdominal pain, nausea, anorexia.
    Gastric acid suppression (e.g., with
    Abdominal tenderness.
    proton pump inhibitors) or bypass Fever and dehydration (especially in severe cases).
    (e.g., enteral feeding) Fulminant CDI may manifest with abdominal distention and severe hypovolemia (e.g., due to
    Recent hospitalization toxic megacolon, paralytic ileus).
    Severe illnesses Severe and fulminant colitis — Clinical manifestations of severe colitis include diarrhea,
    Immune suppression lower quadrant or diffuse abdominal pain, abdominal distention, fever, hypovolemia, lactic
    Inflammatory bowel disease acidosis, hypoalbuminemia, elevated creatinine concentration, and marked leukocytosis .

    PATHOPHYSIOLOGY

    C. difficile is capable of
    elaborating exotoxins ( Toxin A ,
    Toxin B ) that act upon intestinal
    epithelial cells and inflammatory
    cells, leading to tissue injury and
    diarrhea

    DIagnosis treatment Discontinue precipitating antibiotics


    Correct fluid or electrolyte imbalances
    Routine laboratory studies CBC: Initial episode
    Leucocytosis First line :Oral Fidaxomicin or Fecal microbiota
    ↑ Creatinine Oral Vancomycin or
    Oral Metronidazole .
    transplantation may be
    Hypokalemia indicated in recurrent CDI,
    Hypoalbumenia First recurrence severe CDI, or fulminant
    Blood gases (venous or Oral Fidaxomicin
    Oral Vancomycin (tapered and pulsed )
    CDI refractory to antibiotic
    arterial): ↑ lactate,
    Oral Metronidazole therapy.
    Acidosis.
    Stool tests :
    Second or subsequent recurrence
    Tests with high sensitivity : Oral Fidaxomicin or
    Surgical intervention may
    Enzyme immunoassay (EIA) for C. Oral vancomycin followed by oral rifaximin or be necessary for critically
    difficile glutamate dehydrogenase Tapered and pulsed oral vancomycin ill patients or those with
    antigen (GDH). complications
    Fulminant CDI
    NAAT (e.g., PCR) for C. difficile toxins necessitating surgery.
    First-line: high-dose oral vancomycin
    Tests with high specificity: Consider adding IV metronidazole
    EIA for C. difficile toxins A and B. In patients with paralytic ileus, consider adding vancomycin enemas.
    Chhetri Yabhas

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