C. difficile
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| 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
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| what two groups of people can harbor C. diff asymptomatically? | infants and CF patients
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| 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.
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| 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.
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| 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
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| 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.
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| 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
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| what are some complications of PMC? | perforation of the colon, dehydration with electrolyte imbalance, and toxic mega colon which can be life threatening.
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Cgover7
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