6.0 Clostridiodes difficile C.diff

Clostridiodes difficile C diff

gram positive spore forming anaerobic bacteria that

thrives without oxygen

and can survive externally to the host as spores

c diff releases 2 toxins A + B

which damages the colons lining and triggers inflammation and diarrhoea

in the gut good microbes are protective from C diff colonisation

however using broad spectrum antibiotics and gastric acid supression can lead to an imbalance in this protection allowing C diff to overgrow and cause disease

the orgnaism is carried asymptomaticalled, colonised in up to 5% od healthy adults

clinically significant disease almost always follows disruption of the protective gut microbiota

watch video😛

infected or colonised patients shed spores via faeces

spores survive routine cleaning and are resistant to alcohol hand rub,

soap and water must be used by staff members for appriroate hand hygine

alongside protective personal equipment PPF including gloves n aprons

patients admitted to hospital with C diff infecitions CDI are isolated within side rooms to limit spead to other patients

transmission is faecal-oral and amplified in environemnts where patients share bathrooms, equpirment or stadd like hospiutals and long term care facilities

spores can persist on surfaces for months and transmission may occur when apprioriate cleaning standards are not followed

prevention through environmental cleaning and disinfection is vital, chlorine containing cleaning product are required

typical symptoms

• watery diarrhoea, type 6-7

• lower abdominal cramping

• low grade fever

• STINKYYYYYYYYYY DOOKIE

labratory clues

raised white-cell count

severe cases, raised serum creatine from dehydration

severe disease

• profuse diarrhoea with raised white cell count

• significant abdominal tenderness or distension

• lactate > 2mmol L^-1

fulminant/life threatening colitis

• hypotension or shock

• toxic megacolon or bowel perforation

• potential progression to sepsis and miltiorgan failure

complications

dehdyration

toxic megacolon

bowel perforation

sepsis

dehdyration

can lead to significant fluid and electrolyte loss resulting in dehydration which can cause dangerously low blood pressure in severe cases n kidney failure

toxic megacolon

rare condition occurs when the colon becomes enlarged and unable to expel gas and stool

life threating as the colon can rupture and bacteria can enter the blood stream leading to sepsis

required emergency surgery

bowel perforation

c diff/ toxic megacolon can damage the lining of the colon causing a hole to form

leading to peritonisis a danger infection of the abdominal cavity

caused by bacteria leaking from the colon

sepsis

a life threatening condition where the body’s response to infection damages its own tissue organs

risk factors

• Recent or prolonged antibiotic therapy (especially clindamycin, cephalosporins, fluoroquinolones, carbapenems)

• aged 65+

• Hospitalisation or long‑term care facility stay

• Proton pump inhibitor (PPI) or H₂‑blocker use

• immunosuppression (e.g., corticosteroids, chemotherapy, HIV infection, organ transplant drugs)

• Gastrointestinal surgery or manipulation (including feeding tubes, colectomy, or endoscopic procedures)

• Previous C. difficile infection