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Anaerobes

C. difficile

QuestionAnswer
What is the major predisposing factor for acquiring C. diff? Long term antimicrobial therapy which alters the normal flora of the intestines allowing for C. diff to take control
what two groups of people can harbor C. diff asymptomatically? infants and CF patients
What causes the clinical symptoms of CDAD? The toxins given off by C. diff,is mainly toxin A but it is believed that toxins A and B work synergistically.
Describe the TOX A/B Test. It is an immunoassay for the detection of toxins A and B, if the specimen contains the toxins they will bind to the detecting antibody and the immobilized polyclonal antibody during incubation. A color can then be detected, purple means positive.
List other tests for detecting C. diff. Cytotoxicity assay/ tissue culture= best however expensive and slow, latex agglutination, stool culture on CCFYA agar, genetic analysis, endoscopy
If left untreated what can CDAD progress to? Describe this disease. pseudomembranous colitis (PMC)= syndrome in the large bowel characterized by a layer of necrotic tissue and dead inflammatory cells.
After the C. diff diagnosis has been made what actions should be taken? what treatment should one be given? Antibiotic therapy should be stopped where possible, avoid antidiarrheal agents and narcotics which could decease toxin clearance, and fluid replacement to stay hydrated. Metronidazole is 1st recommended, then vancomycin
what are some complications of PMC? perforation of the colon, dehydration with electrolyte imbalance, and toxic mega colon which can be life threatening.
Created by: Cgover7