1. Introduction a. Background
Antibiotics-resistant organisms have become one of the most serious threats to public health, infecting over two million people and killing approximately 23,000 people annually.1 According to the CDC, “total inappropriate antibiotic use,” such as prescribing unnecessary antibiotics or giving the wrong dose or duration, makes up to 50% of all outpatient antibiotic use,2,3 and in 2009, the United States spent $10.7 billion on antibiotics, indicating that there is a lot of potential money to save.4
Furthermore, in the past 10-15 years, Clostridium difficile infection (CDI) has emerged as an increasingly important infectious disease worldwide. C. difficile is an antibiotic-associated bacteria that causes asymptomatic
Clostridium difficile associated disease will resolve when the patient discontinues taking the antibiotics to which he/she has been previously exposed (Nipa, 2010). Administration of a different antibiotic is used to treat the infection (Grossman, 2010). The infection can usually be treated with an appropriate course of about 10 days of antibiotics including metronidazole or vancomycin administered orally (Nipa, 2010). On occasion intravenous vancomycin may be necessary (Gould, 2010). The nurse should ensure patients are not only taking the newly prescribed antibiotic, but also responding to the treatment by showing a decrease in symptoms. Symptoms can recur despite antibiotic therapy, close monitoring is essential. In order to avoid risk of further complications, nursing interventions would include careful assessment of white blood cell count, temperature, and hydration status; meticulous skin care and assistance with bowel elimination given the loose frequent stools; and management of abdominal discomfort (Grossman, 2010).
It is thought that overuse of antibiotics is related to the development of antimicrobial resistance (AMR) (Austin). As a consequence, there has been an increasing trend to promote appropriate prescribing of antibiotics so as to maximise their therapeutic efficacy and minimise the outbreak of resistance. Antimicrobial stewardship (AMS) programs in hospitals are exemplary of a method used to promote rational prescription of antibiotics. In this review, we will briefly introduce some examples of AMR to illustrate the extent of this issue. We will then move on to describe AMS programs and the strategies required to
This paper will mainly explain what Clostridium difficile is, its causal agent, epidemiology, ways of transmission, some clinical features, diagnoses and how to test for the bacterium, treatment, prognosis, and preventative measures. There are treatments available for this
Clostridium difficile is a Gram-positive, spore-forming, rod-shaped bacillus that is renowned for being the leading cause of hospital-acquired diarrhea in adult patients. C. difficile is present as normal intestinal flora within 3% to 5% of healthy people2, while its spores are ubiquitous in the environment, especially in hospital settings. It grows at an optimal temperature and pH of 37ºC and 6.5–7.5 respectively.1 It is an obligate anaerobic as it thrives in the absence of oxygen. It is highly motile with the presence of peritrichous flagella, which are evenly spread out along its surface. As briefly mentioned above, this evolving pathogen produces endospores. The bacterium produces dormant spores, which are extremely hardy and resistant to antibiotics, the host’s innate immune system, and once shed into the environment through the host’s feces, they are resistant to unfavorable aerobic conditions3 as well as several types of bleach-free disinfectants, which are commonly used in hospitals.3 The spores will germinate under the favorable conditions of the intestinal tract, resulting in the multiplication of vegetative cells, colonizing in the gastrointestinal tract. The vegetative cells release two powerful exotoxins upon adherence to the epithelial cells of the GI tract. Pathogenic strains of C. difficile produce two exotoxins: toxin A and toxin B. Toxin A is an enterotoxin that causes fluid excretion, resulting in fluid accumulation and watery diarrhea. Toxin B is a potent
Clostridium Difficile (C-Diff) is considered one of the most common infections a patient can acquire within their hospital stay. It is estimated that C-Diff is responsible for 337,000 infections and 14,000 deaths a year (Centers for Disease Control and Prevention, 2012). Working in the emergency department (ED), I have witness first hand how debilitating this gastrointestinal infection can be. Patients are admitted to the ED for having severe watery diarrhea, abdominal pain, and fever. Elderly patients are at increase risk for sepsis and dehydration related to recurrent infections. Appropriate management and education of C-Diff is optimal for patient survival and decrease contamination across lifespan.
A couple times a year local and national mass media put the spotlight on problems connected to antibiotic overuse. Some people consider those problems to be real and serious, and others think that the discussed topics are nothing more than new “fashionable” subjects to talk about, distracting people from “real” problems, such as climbing gas prices or war expenses. Meanwhile, antibiotic overuse continues as a common practice among US doctors and agribusinesses for the last 20 years. The practice of antibiotic overuse has put patient’s health at risk, contributed to antibiotic resistance and increased bacterial mutation to a new, stronger level; as well as it hitting the economy with new costly expenses in health care. It is time to stop
Throughout my life, adults have insisted the use of antibiotics to fight against the most inconsequential illnesses, whether it’s the cold or the flu. However, neither illness is due to invasion of bacteria. This misuse can lead to antibiotic resistance, also known as antimicrobial resistance(AMR), currently one of the central issues facing the public health system. While the process for antibiotic resistance occurs naturally through the process of adaptation, the mismanagement of antibiotic resources has accelerated the rate at which the bacteria adapt. The occurrence of this misinformation isn’t limited to a few adults: even some of my peers suggest taking antibiotics when faced with the flu. This leads to asking whether AMR is truly a problem and are present regulations enough to combat the issue.
Many Americans die each year from complications connected to Clostridium difficile. It can ill a significant number of individuals as well as animals. The Clostridium difficile infection is the result of poor hygiene, misuse, overuse of antibiotics and an aging population. In this paper I will be discussing the following topics, what clostridium difficile means, what it causes, signs and symptoms, complications, treatment and the prevention.
Clostridium difficile, also known as C. diff, is a bacterium that causes severe symptoms, including inflammation of the colon, which can be life threatening (Centers for Disease Control and Prevention, 2015). It is a very common infection that affects hundreds of thousands in the United States alone. If not caught and treated early, it can be deadly. I kills thousands of people in the United States every year (Mayo Clinic Staff, 2017). It is extremely important to learn the signs and symptoms of this infection so treatment can begin as early as possible.
Clostridium difficile involves a gram-positive spore-forming bacterium, which is a normal element of the colon flora in people. The Clostridium difficile can cause antibiotic-associated diarrhea when the competing bacteria in the gut flora are all killed by antibiotic treatment. The Clostridium difficile infection is one of the serious healthcare-related infection and also a rising health care problem. In the early 1970s, the Clostridium difficile has been known to have the ability to cause pseudomembranous colitis. As stated, the infection is the most cause of nosocomial infectious diarrhea (Aktories & Wilkins, 2000). Individuals that are colonized with clostridium difficile serve as the reservoir for infection and this is by contaminating the environment with spores of such bacteria. This will lead to the spread of the organism on the health care worker’s hands or even through the use of medical equipment. In this paper, we are going to focus on the effective prevention strategies for clostridium difficile. What are the effective prevention strategies for clostridium difficile?
The healthcare professional can expect to encounter various conditions within their scope of experience. Clostridium difficile represents one of the most common and challenging nosocomial infections that can cause life-threatening complications such as hypervolemia, sepsis, pain, and peritonitis (Grossman and Mager 155). The recognition, diagnosis, treatment and inhibition of transmission of this bacterium are imperative in order to limit infection and prevent death.
Ample literature has been published to elucidate the pervasive nature of Clostridium difficile and its relationship with inadequate health-care practices. Clostridium difficile-associated disease: New challenges from an established pathogen by Sunshine and McDonald, published in the Cleveland Clinic Journal of Medicine discusses the concern over Clostridium difficile. It includes a case report involving infection caused by the bacterium and important guidelines for prevention and treatment associated with the bacterium.
Clostridium difficile, a nosocomial pathogen, is of critical importance. By 2010 it was the most prevalent healthcare-related pathogen globally [1], accounting for 20-30% of antibiotic-associated diarrheal cases in healthcare settings [2]. Symptoms of C. difficile infection (CDI) are significant and include severe diarrhea and dehydration. In more serious cases, CDI can result in pseudomembranous colitis, bowel perforation, sepsis and even death [3, 4].Beyond serious impact upon patients, CDI is costing multiple billions of dollars in hospital care in the United States alone [5]. Clearly the need exists to identify and characterize the infection and toxicity pathways of C. difficile.
The overuse of antibiotics has been a problem for well over a decade. This misuse leads to many nonvisible problems arising within the human population. As the use of antibiotics increases, the number of antibiotic resistant bacteria also increases. When bacteria become resistant to an antibiotic, another antibiotic must be used to try and kill it and the cycle becomes vicious. Michael Martin, Sapna Thottathil, and Thomas Newman stated that antimicrobial resistance is, “an increasingly serious threat to global public health that requires action across all government sectors and society” (2409).
According the World Health Organization (WHO), antibiotic resistance is one of the world’s greatest health threats to date (Haddox, 2013). In the article, The Health Threat of Antibiotic Resistance, Gail Haddox (2013) discusses the danger antibiotic resistance poses in today’s society and strategies to prevent the expansion of antibiotic resistance. In Europe alone, an estimated 25,000 deaths have been attributed to multi-resistant infections (Haddox, 2013). Common infections are now harder to treat due to the increased resistance to antibiotics across the world, in fact some are becoming untreatable. Antibiotics should be treated like oil, a non-renewable resource (Haddox, 2013).