CLOSTRIDIOIDES DIFFICILE INFECTION (C DIFFICILE)

what is a Clostridioides Difficile Infection?

• a spore forming toxin-producing gram positive bacterium

• transmission via fecal-oral route

• causes antibiotic associated colitis

• antibiotic use alters the normal gut flora and leads to colonization and overgrowth of c diff

• spores from diarrhea survive outside body on skin, clothes, environmental surfaces and recur

what are risk factors of a Clostridioides Difficile Infection?

• recent or prolonged antibiotic use

• age>65

• current/recent hospitalizations

• living in a longterm care facility

• use of proton pump inhibitors or immunosuppressants

what are clinical manifestations of Clostridioides Difficile Infection?

• profuse water diarrhea

  • monitor for cdiff if > 3 loose stools within 24 hours

  • not bloody

• abdominal pain/cramping

• nausea and anorexia

• fever and increased WBCs

• dehydration

how is a Clostridioides Difficile Infection diagnosed?

• stool sample

  • marked leukocytosis (increased WBC)

  • positive stool PCR for C difficile

what complications can occur with Clostridioides Difficile Infection?

• toxic megacolon

  • life-threatening colonic perforation

• dehydration

  • hypovolemic shock

• electrolyte abnorms

  • hypokalemia

  • hyponatremia

  • hypomagnesemia

• perianal skin breakdown

  • contaminated wounds

what are nursing interventions for a Clostridioides Difficile Infection?

• contact precautions:

  • wash hands with soap and water not alcohol based products

• antibiotic usage:

  • vancomycin or fidaxomicin

• measure orthostatic pulse and BP

• monitor electrolyte levels/status

• fluid status

• assess for abdominal distension and guarding

  • may indicated toxic megacolon

what should a nurse teach the patient about Clostridioides Difficile Infection?

• recurrence is common

• inform HCP of history of cdiff infection whenever antibiotics are prescribed

• apply skin barrier creams (petrolatum, zinc oxide)