Clostridium difficile infection – Quick review card

Gram +ve anaerobic spore-forming bacillus Part of normal intestinal flora in 1-3 % of adults and 15 % to 20 % infants Major cause of antibiotic related diarrhoea and pseudomembranous colitis Incidence and mortality has increased in both hospital and community settings worldwide Source of infection can be endogenous ( via the carrier strains ) and exogenous through infected individuals , contaminated healthcare workers , nosocomial sources and contaminated environment Pathogenesis is by disruption of colonic flora , colonization and production of toxin A ( an enterotoxin ) and toxin B ( a cytotoxin ) and other putative virulence factors

Presence of other comorbidities as abdominal surgery , CKD , inflammatory bowel disease , immunosuppression

If this is a 1st episode or relapse / recurrence

Severity of infectionas per PHE this can be mild , moderate or severe or life threatening

Factors as age , frailty , comorbidities

seek advice promptly from a microbiologist or infectious disease specialist before commencing treatment ( a notification would generally come from the hospital to discuss the situation ) if oral route not possible seek advice from a gastroenterologist or pharmacist about alternative routes as NG tube / rectal catheter do not offer loperamide...