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What is C-Diff

Clostridium Difficile
All You Need To Know About C-diff

Often times, it is the little-known diseases, conditions, and bacterial infections that are the deadliest. One such condition is that of Clostridium Difficile (popularly referred to as C-diff or C. Difficile). C. Difficile gets its name from the Clostridium Difficile which is a deadly type of bacteria that causes an infection and inflammation of the colon (colitis) causing diarrhea and colitis by disrupting normal colonic flora. The condition can be found in both adult and children and are usually found among hospitalized patients following a treatment round of antibiotics that induce and disrupt the normal colonic flora [4].

What is C-Diff

C-Diff is a little-talked-about disease that exists all around us in the water, air, soil, and fecal matter from humans and animals. Importantly, the C-Diff bacteria is so common that many people can have the bacteria in their intestines and never have any symptoms of the same. Of course, not knowing that the disease-causing bacteria are present, can result in its further spread. Symptoms of the condition include loss of appetite, weight loss, dehydration, severe diarrhea (like 10+ times a day), cramps, fever, nausea, and an unusually fast (rapid) heart rate. Should these symptoms persist for more than a day, then one should visit a doctor right away [1].

How is C-diff Spread

Ironically, one of the most common places to contract C-Diff is health care facilities. This is due to the fact that are givers and health practitioners are more likely to come into contact with the bacteria and spread the same to other patients and individuals within the care facility that they (the caregivers) come into contact with it. Contracting this type of bacteria can happen based on coming in contact with clothing, sheets, and other kinds of surfaces that have come in contact with feces and then with nose or the mouth. A failure to wash one’s hands after coming into contact with the bacteria can contribute to spreading in this manner [1].

What is the Cause of C-Diff

As intimated above, antibiotics play a key role in contracting C-Diff, as they can trigger the condition. Triggering antibiotics include penicillins, cephalosporins, fluoroquinolones, and clindamycin. Older adults facing some of these conditions will be more at risk — particularly if taking antibiotics is a part of the equation. Still, research shows that an increasing number of younger people are contracting and living with the condition even without being in healthcare facilities like hospitals or taking antibiotics. Additionally, dealing with any other condition like an Ulcerative Colitis, inflammatory bowel disease, a weakened immune system, and colorectal cancer, can increase the likelihood of contracting C-Diff [1].

It is important to note that there is the emergence of an aggressive new strain of C. Difficile that has an increased number of toxins, is resistant to certain existing medications and treatments and is shown to be present in people who have not taken antibiotics or been hospitalized [6].

Treatment for C-Diff Bacterial Infection

Although deadly, there are a few treatment options that are available for people who have been diagnosed with C. Difficile, and most people make a full recovery within one to two weeks [3]. Although the use of antibiotics can trigger C-Difficile, some types can target and treat the condition. Vancomycin, Fidaxomicin, and Metronidazole (Flagyl) are among the antibiotics used to treat C-Diff. Each of these has their own side effects [2]. A 10 to 14 day course of these antibiotics to kill C-Diff is typically recommended treatment but for the more aggressive strain a longer treatment course will be prescribed [3].

Side Effects of C-Diff Antibiotics

I. Metronidazole: this is antibiotic is taken orally and is taken by the mouth. It is used primarily for mild to moderate forms of the infection even though it is not approved by the FDA [5]. Usually, over 95% of patients will respond positively to oral metronidazole and experience the improvement of diarrhea within 2 to 3 days, and a clearing of all symptoms within 7 to 10 days. A common side effect includes nausea and a bitter taste in one’s mouth [5], loss of appetite, belly pain, and diarrhea [8].

II. Vancomycin (Vancocin): Also taken orally, this antibiotic is administered for more severe and/or recurrent cases of C-Diff infections [5]. It is also more expensive than metronidazole and is usually prescribed for those who are more pregnant, younger than 10 years old and are generally unresponsive to metronidazole [4]. Importantly, Vancomycin is also more expensive and may promote Vancomycin-resistant bacteria [5]. Nausea, pain in the belly, and low potassium are common side effects [8].

III. Fidaxomicin (Dificid): Like Vancomycin and Metronidazole, Fidaxomicin is taken orally. However, the antibiotic is significantly more expensive than both but has been shown to have lower rates of infection recurrence [5]. Vomiting, nausea, anemia (low red blood cell count), neutropenia (low white blood cell count), and belly pains are common side effects [8].

For a full list of side effects, which are many, go to http://drugs.com

Other C-Diff Treatments

In addition to administering the antibiotics mentioned above, another treatment for Clostridium Difficile Colitis include the following [5].

A. Surgery — used to remove the diseased parts of the colon in extreme cases where there is inflammation of the lining of the abdominal wall, severe pain, toxic megacolon, or organ failure [5].

B. Fecal Microbiota Transplant (FMT) or more commonly known as Fecal Transplant — a stool transplant that is an emerging alternative treatment that is specifically directed at patients who have recurring C-Diff infections. FMT has been shown to have a success rate of up to 90% [5].

C. Probiotics — these are organisms (yeast and bacteria) that helps restore and maintain a healthy balance in the intestinal tract. One yeast in particular (Saccharomyces boulardii), when combined with antibiotics has shown it might help prevent recurrent C-Diff infections [5].

Percentage of C-Diff Deaths

In 2011, the CDC (Centers for Disease Control and Prevention) recorded that nearly 500,000 contracted C. Difficile in the United States. Of that amount, approximately 29,000 people died within 30 days of their diagnosis — placing the percentage of those dying from a C-Diff infection at approximately 5.8% [7].

Sources:

[1]  https://www.webmd.com/digestive-disorders/clostridium-difficile-colitis#1
[2] https://www.webmd.com/digestive-disorders/clostridium-difficile-colitis#2
[3] https://www.nhs.uk/conditions/c-difficile/
[4] https://adc.bmj.com/content/88/4/342
[5] https://www.mayoclinic.org/diseases-conditions/c-difficile/diagnosis-treatment/drc-20351697
[6] https://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691
[7] https://www.medicalnewstoday.com/articles/321704.php
[8] https://effectivehealthcare.ahrq.gov/topics/c-difficile-update/consumer

 

 

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