Clostridium Difficile

BarbPick · Dec 4, 2003

"C Diff" is the new "in" bacteria. Used to just be mersa and people would run. You see it these days as a gastroenteritis. Since they discovered it, they now get a lot of money to treat it.

They can give cipro, but flagyl is less expansive and they are saving the cipro for anthrax. I am not kidding, they really do not want us to get a tolerance to Cipro, we might need it later.

clostridiums are well known like botulism, and they found a way to market that for plastic surgery.

Put it in your search engine, see what you find

DoctorRN · Dec 4, 2003

Originally posted by BarbPick
"C Diff" is the new "in" bacteria. Used to just be mersa and people would run. You see it these days as a gastroenteritis. Since they discovered it, they now get a lot of money to treat it.

They can give cipro, but flagyl is less expansive and they are saving the cipro for anthrax. I am not kidding, they really do not want us to get a tolerance to Cipro, we might need it later.
clostridiums are well known like botulism, and they found a way to market that for plastic surgery.

Put it in your search engine, see what you find

From emedicine.com:

Background: Clostridium difficile is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile was first described in 1935 as a component of the fecal flora of healthy newborns and was initially not thought to be a pathogen. It was named difficile because it grows slowly and is difficult to culture. While early investigators noted that the bacterium produced a potent toxin, the role of C difficile in antibiotic-associated diarrhea and pseudomembranous colitis was not elucidated until the 1970s.

C difficile infection commonly manifests as mild-to-moderate diarrhea, occasionally with abdominal cramping. Pseudomembranes, adherent yellowish-white plaques on the intestinal mucosa, occasionally are observed. In rare cases, patients with C difficile infection can present with an acute abdomen and fulminant life-threatening colitis. Approximately 20% of individuals who are hospitalized acquire C difficile during hospitalization, and more than 30% of these patients develop diarrhea. Thus, C difficile colitis is currently one of the most common nosocomial infections.

The diagnosis of C difficile colitis should be suspected in any patient with diarrhea who has received antibiotics within the previous 2 months and/or when diarrhea occurs 72 hours or more after hospitalization.

for the complete article: http://www.emedicine.com/med/topic3412.htm

Mimi2RN, ASN, RN · Dec 4, 2003

I had C. Diff after surgery w/ abx followed by two 10 day stretches of IV Rocephin, at home. It probably killed off all the good bacteria in my gut. I was given 14 days of Flagyl to clear it up.

I eat more yogurt, now. The ones with "live and active cultures". I figure my intestines need all the help they can get!

Long Term Care Columnist / Guide · Dec 4, 2003

C. diff. in 2 words (while holding nose): PEEEE-EEEEEEW!! It's like a GI bleed.......once you've smelled it, you never forget it, because NOTHING smells quite like it. I've "diagnosed" it in patients 30 feet down the hall, just by sniffing the air. It's devilishly hard to get rid of, too.......sometimes, the 10 days of Flagyl don't eradicate it entirely........and I've seen it spread through an entire skilled-nursing wing like a rumor due to simple carelessness on the part of staff who failed to wash their hands adequately between patient contacts. It's a nasty, nasty illness, and in the elderly it can be disastrous, what with the potential for dehydration and electrolyte imbalances. YUK.

indie · Dec 4, 2003

Seems to me to be a common (nosocomial?) infection in the immunocompromised. A little like PCP, but in the gut. Yes?

DoctorRN · Dec 4, 2003

Originally posted by indie
Seems to me to be a common (nosocomial?) infection in the immunocompromised. A little like PCP, but in the gut. Yes?

It doesn't require immunocompromise per se. Patients with intact immune systems get it just as often as the immunocompromised.

It is a matter of killing off the normal gut flora and anyone on antibiotics can have that happen.

Just another fine example of why everyone with the sniffles doesn't need to be put on antibiotics.

Agnus · Dec 5, 2003

If not already initiated your C-Dif pt. needs to be put on contact isolation.

bellehill, RN · Dec 5, 2003

The floor I am on just got done with a round of C.DIff positive patients. They were all put on isolation and treated with Flagyl IV/PO depending on the pt. One of the nastiest smells I have ever enountered was a C.Diff infection. Thankfully the floor is mostly cleared now. :)

purplemania, BSN, RN · Dec 5, 2003

Now that you have read these posts, please be more tolerant when your pediatrician does not automatically prescribe antibiotics for your sick kid. We had to educate parents to the fact that a cold, or flu or other viral conditions, are not treated with antibiotics and the overuse of AB may cause other problems. C. Diff is seen fairly frequently in pedi wards.

mattsmom81 · Dec 5, 2003

Originally posted by Agnus
If not already initiated your C-Dif pt. needs to be put on contact isolation.

Recently I placed anew admit from LTC in contact isolation. He had a recent CDiff dx, just started on ABX for it, had not been cleared by culture, was still having diarrhea. I put him in contact iso pending further studies...figuring better safe than sorry.

The IM doc poo poo'd my actions stating CDiff is not infectious so what am I worried about. We are hearing this more and more. :confused:

So my question is: IS there new research that says there is no need for isolation? Anybody know for sure?

Our infection control nurse is not helpful with these things....rules change daily. I suspect most decisions regarding infection control are made on a $$ and customer service basis, like most things in HCA facilities. We frequently have trouble locating PPE...and getting more when we run out. Administration is hesitant to anger family who complain that their loved one doesn't need isolation. Doctors seem to be falling in line behind administration (course they seldom enter rooms for more than 30 seconds) and are generally unsupportive when we attempt to isolate TB, MRSA, VRE, etc.

Anybody have any suggestions about how nurses can protect themselves and their patients in these circumstances? Anybody else work with docs and administrators who do this?

I recently shared on Allnurses a coworker's dilemna and I'm starting to worry about all nurses' health at this facility. She developed MRSA sepsis that ate away her vertebral bones. This facility is lax in infection control yet have denied her worker's comp claim, stating 'she could have gotten this anywhere'.

Sorry so long...this issue is bothering me. Any input appreciated.

Geeg · Dec 5, 2003

One poster noted not to use Cipro d/t preventing resistance, also Cipro has been implicated in tendonitis, and has even caused rare cases of rupture.