Clostridium difficile infection is an infection of the intestine. It is caused as a result of a negative change of the normal and healthy bacteria in the colon. This is mostly caused by the intake of some antibiotics.
CAUSES OF CLOSTRIDIUM DIFFICILE
C. difficile bacterium has two forms; the infectious and active type that cannot survive in an environment for a long time, and a non-infectious and non-active type that can survive in an environment for a very long time, it is called SPORE. Although the non-active type of c. difficile cannot cause infection directly, it can be active and turn to be infectious once it‘s been ingested. The bacteria are passed through feces, to objects and surfaces, and then to the food, when the infected person does not wash their hands properly. Therefore, we can say poor personal hygiene contributes greatly to the spread of c. difficile bacteria.
These bacteria are mostly found in:
- Nursing homes
- Care facilities
- Furniture surfaces
- Toilet seats
- Kitchen cabinets
However, research has proven that most people get infected with c. difficile when taking antibiotics. Antibiotics do not only kill bad germs, but they also kill the good germs that prevent and fight against infections. It is very much possible to get infected with c. difficile if one takes an antibiotic for a long time. Example of such antibiotics are, penicillin, clindamycin, cephalosporin, fluoroquinolones, etc
SYMPTOMS OF CLOSTRIDIUM DIFFICILE
- Frequent smelly diarrhea.
- Abdominal cramps.
- Weight loss.
- Kidney failure.
- Blood in the stool.
- Loss of appetite.
- High temperature
It is advisable to visit a doctor when the following are been noticed.
- Severe pain in the abdomen
- Constant fever
- Frequent watery stooling in a day
- Symptoms lasting for more than two days
DIAGNOSIS OF CLOSTRIDIUM DIFFICILE
- Stool test: Several laboratory tests can be used to detect the presence of C. difficile bacteria and the harm it has done to the body system. These tests are carried out on a stool sample.
- Enzyme immunoassay test is not all that reliable to give the right results most times. Although it is a fast method, it does not have the sensitivity to detect many infections.
- Cell cytotoxicity assay test is an uncommon type of laboratory test that helps detect C. difficile on human cells grown in culture. It is a test that requires a lot of procedures, also it might take 24 to 48 hours for test results.
- The polymerase chain reaction test is a very fast and reliable way to detect the presence of c. difficile toxin B gene in a stool sample
- Glutamate dehydrogenase enzyme immunoassay
- Latex agglutination technique
- Imaging test: This is the process of viewing the colon through an abdominal x-ray or computerized tomography scan, which helps to detect any complications in the lining of the colon. Examples of such complications are a hole in the lining of the colon, thickening of the colon wall, expansion of the bowel, etc.
- Colon examination: This is done by inserting a flexible tube with a camera attached to it at one end into the patient’s colon to view areas that have been irritated and also the pseudo membranes. This test can also be called colonoscopy or flexible sigmoidoscopy.
TREATMENT OF CLOSTRIDIUM DIFFICILE
The first thing step is to stop the intake of anything that might have been noticed to trigger the infection before any other treatment can be effective.
- Surgery: A surgery can be done to remove the affected part of the colon. This can be the only option for patients with organ failure, inflammation of the lining of the abdominal wall, or toxic megacolon.
- Antibiotics like metronidazole, vancomycin, and fidaxomicin can help stop c. difficile from growing, stop diarrhea, and other complications.
- Metronidazole is given orally to a patient who has been diagnosed with C. difficile diarrhea. Although it can be given temporarily to the patient, even before diagnosis.
- Vancomycin is given orally to patients who are not responding to metronidazole treatment. It might be because they are allergic or resistant to metronidazole. Vancomycin is best for pregnant patients and those under 20 years of age, or a C. difficile colitis patient.
After treatment, a recurrence might happen if;
- The patient is taking antibiotics for a different health condition while being treated for c. difficile infection.
- The patient is having some critical medication conditions like chronic liver disease, inflammatory bowel disease, kidney failure, etc.
However, antibiotics and probiotics such as bacteria and yeast can be used as a treatment, because they help to treat and prevent the infection.
Some home remedies and changes in lifestyle can also serve as treatments for c. difficile infection. A patient that has watery diarrhea is expected to consume more of the following foods.
- Crackers etc.
Taking plenty of fluids containing water, salt, and sugar are also highly recommended.
CLOSTRIDIUM DIFFICILE IN INFANTS
For kids with clostridium difficile, there is the presence of C. difficile in their stool, although they may not show signs and symptoms, diarrhea is the common symptom associated with the infection. Even some times, adults with C. difficile do not show symptoms.
A child with a weak immune system has a higher risk of getting infected, also if a child has been on antibiotic medication or has been hospitalized.
Infants with C. difficile may show the following symptoms,
- Mild watery diarrhea; Which might last for a short time or a long time, it all depends on the body system of the child
- High fever
- High white blood cell count
- Pseudomembranous colitis
A fecal test (stool test) can be done to diagnose a child of the infection. This test will prove the presence of the bacterium in the stool. It is the simplest method that can be used.
Metronidazole 30mg for 10 days can be given orally to an infant who has been diagnosed to have C. difficile, it is usually the first choice of antibiotics. Vancomycin 40mg can then be given orally for 2 weeks if the child is showing some allergic reaction to metronidazole.
However, children who have been treated for C. difficile might show symptoms again within a short period after been treated, this does not mean that the treatment was not properly done. This is because the spores are active and remain in the body after the first treatment. In patients with frequent recurrence, antibiotics such as rifaximin or fidaxomicin might be prescribed.
Note: antibiotics are not to be given to children younger than 3 months.
Clostridium difficile infection causes dehydration in children, it is, therefore, important to give an infected child plenty of fluid. To avoid further spread, proper washing of the hands and cleaning of the fingernails is very important.
PEOPLE WHO ARE AT RISK OF CONTACTING C. DIFFICILE INFECTIONS
- People that use antibiotics for a very long time
- People within the age of 65 – 70
- People who stay in a hospital for a long period of time
- Those who have once been treated for the infection
- Those who have a weak immune system
- People with critical medical conditions
- Those on proton pump inhibitor, to reduce the amount of stomach acid they produce
- Those who have had surgery on their digestive system
- People with underlying diseases like diabetes, or a side effect of treatment like chemotherapy.
HOW TO PREVENT GETTING INFECTED
- Washing the hands and cleaning of the fingernails with water and soap, after using the bathroom
- Cleaning of the toilet and bathroom frequently, especially if it is been used by a person who has diarrhea. This is to prevent a healthy person from been infected.
- Do not have contact with an infected person
- Avoid the use of antibiotics every time
- Use antibacterial hand sanitizer
- Wash your hands before cooking and eating
- Ensure that your doctor or nurse washes his or her hands properly before touching you.
An untreated case of C. difficile can lead to the following
- Kidney failure
- A hole in the large intestine
- Toxic megacolony
HOW IS CLOSTRIDIUM DIFFICILLE LINKED WITH COLITIS?
The infection of the colon caused by C. difficile bacterium, which produces toxins that irritates the lining of the colon (mucosal inflammation) is called clostridium difficile colitis.
Clostridium difficile is an intestinal infection.
SYMPTOMS OF CLOSTRIDIUM DIFFICILE COLITIS.
- Anorexia nervosa: Is an eating disorder, characterized by abnormally low body weight, with a great fear of been overweight. It is a psychological life-threatening eating disorder.
- Malaise: is when you feel weak, overall discomfort or a lack of well-being, caused by viral infections, heart disease, etc.
- Cramping abdominal pain
- Mild diarrhea
HOW TO MANAGE CLOSTRIDIUM DIFFICILE
Eat soft and plain foods like
- Cooked cereal
- Properly cooked vegetables
- Juice mixed with plenty of water
Avoid foods that are hard to digest and spicy or fatty foods like
Avoid self-medication. Ibuprofen, naproxen, and aspirin can cause stomach bleeding and other complications. All medications should be prescribed by a doctor.