Clostridium difficile is a bacterium that normally lives in the gut for some people. In he althy carriers, it does not cause any problems, but if the balance of the intestinal flora is disturbed, it leads to diarrhea and even to inflammation of the intestines. What are the pathways and symptoms of Clostridium difficile infection? What is the diagnosis and treatment of infection with this bacterium?
What is Clostridium difficile?
Clostridium difficileis a bacterium belonging to the genusClostridium- gram-positive anaerobic bacteria, which produce spores, i.e. forms that enable these bacteria to survive unfavorable conditions (e.g. intensive and meticulous treatment). This group of bacteria also includes gas gangrene(Cl. Perfringens ,Cl. Histolyticum ), botulinum toxin ( Cl. botulinum ) and tetanus (Cl. tetani).
Clostridium difficilenormally occurs in the large intestine in about 2/3 of infants and children and in about 3% of adults. In he althy people, it does not cause any he alth problems, because its growth is inhibited by the natural intestinal flora of the body (by "good" intestinal bacteria). However, when it becomes disturbed, the bacteriumClostridium difficilecan multiply and produce bacterial toxins that damage the cells of the gut wall and lead toinflammation of the gut .
It should be noted that individual strains of bacteria differ in terms of pathogenicity. There are significant differences in quantity and in terms of the type of toxins produced and the severity of symptoms between strains. There are strains of bacteria that are highly resistant to treatment and cause severe gastrointestinal infections with high mortality.
Causes of clostridium difficile infection
The cause of the imbalance of the bacterial flora in the intestines are usually broad-spectrum antibiotics, especially those taken in larger amounts (more than one) and for a longer period (more than 10 days). Antibiotics destroy the normal flora of the gut, which fosters the growth of less susceptible species of bacteria such asClostridium difficile . This bacteriumIt is characterized by high resistance to most antibiotics, so it can easily develop in the digestive tract of a person who takes this type of medication.
Other factors that increase the risk of infection are:
- partial or full immobilization
- drugs that reduce immunity
- chemotherapy
- age - people over 65
Infection occurs in about 20 percent. patients in hospital and most of them treated with antibiotics. This means that the risk of infection increases in proportion to the duration of hospitalization.
Bacteria are spread through spores that leave the body with the feces of an infected person. They can then contaminate the environment: toilets, bedding, skin, and clothing. They can also spread with the air (e.g. when making beds), so it is not difficult to get infected. Therefore, the indirect cause of infection is lack of hygiene.
The infection with this bacterium occurs most often in patients taking antibiotics. Infection is spreading in hospitals.
Symptoms of Clostridium difficile infection
Signs of infectionClostridium difficileare:
- acute watery diarrhea without blood
- fever
- flatulence
- stomach pains
Ww. symptoms may appear from a few days to three weeks after the end of antibiotic treatment.
Clostridium difficileis the cause of colitis, sometimes with a fulminant course, and life-threatening. In 10-15 percent patients may develop intestinal obstruction.
Antibiotic-related diarrhea, which is a mild condition dependent on other microorganisms, should be distinguished from the colitis caused by this bacterium.
Clostridium difficile infection diagnosis
The test that confirms the diagnosis is the examination of the stools for the presence of these bacteria and their toxins. In some cases, colonoscopy is performed, and in patients who are contraindicated in this type of examination, computed tomography is performed.
Treatment of Clostridium difficile infection
Treatment of Clostridium difficile infection includes fluid and electrolyte replacement (parenterally) and targeted antibiotic therapy. However, this does not always work, as bacteria are increasingly resistant to drugs.
If the large intestine is dilated and blocked, surgical treatment is required to repair the intestinal damage.
Important- The correct treatment of the infection does not always mean the cure of the sick person. Clostridium difficile forms spore forms which are the cause of frequent (10-25% of cases) relapses of the disease. Their elimination is practically impossible, which can lead to chronic dysbiosis in the digestive system, a condition in which there are significant differences in the normal bacterial flora of the intestine.
- The most serious effects of the infection are pseudomembranous enteritis (a disease that is often severe and difficult to treat), acute distention of the colon, and even perforation of the large intestine (colon perforation) and sepsis (blood poisoning).
- Infection can be life-threatening in the elderly or those who are immunosuppressed.
How to prevent Clostridium difficile infection?
First of all, you need to take care of hygiene, especially when visiting hospitals and nursing homes. In these types of places, it is better not to sit on sick beds, and wash your hands with soap and water each time you leave the hospital room, especially if the person you are visiting has had diarrhea or has had diarrhea. It is also better not to take small children to this type of place.
It is worth adding that scientists are also working on an oral vaccine against C. difficile infections.