Lightning Learning: Clostridium Difficile
“Regular gut bacteria normally keep C. difficile in check. However, antibiotic use can disrupt this balance, leading to the bacteria multiplying and producing a toxin.”
What?
C. difficile can be found in a normal colon, however normal gut bacteria keep it in check so the person remains asymptomatic. Antibiotic use can disrupt this balance, leading to the bacteria multiplying and producing a toxin.
Most common symptoms? Watery diarrhoea, Abdominal pain, Fever
Most common causative antibiotics? Ampicillin, 2nd and 3rd generation cephalosporins, Clindamycin, Fluoroquinolones
Why?
Outside of the body it becomes a resistant spore which survives for long periods unless surfaces are thoroughly cleaned. Be warned... it is HIGHLY INFECTIOUS!
Causes inflammation of the colon (pseudomembranous colitis). Diagnosis with stool samples – immunoassay and PCR.
Management?
Stop antibiotic and PPI
Oral metronidazole, in mild to moderate cases unless contraindication (oral vancomycin is alternative)
Oral Vancomycin in more
Severe disease
Complications include ileus and toxic megacolon (see pic)
Further Reading:
- BMJ Best Practice: Clostridium difficile: Summary
- NHS Choices: How you get C. difficile
- GOV.UK: Clostridium difficile: guidance, data and analysis
