Clostridium difficile - An antibiotic-associated infection

Antibiotic use allows infecting C. difficile bacteria to take over intestines and wreak havoc.   Causing damage, inflammation and severe diarrhea

C. difficile is an infectious, antibiotic-resistant, toxin-producing bacteria (usually accidently ingested in a hospital, nursing home, assisted-living or similar community facility).   C. Diff overruns the normal gut flora (most often in immuno-compromised /elderly patients) after this beneficial flora has been wiped out by a broad spectrum antibiotic

C. difficile infection is sometimes misdiagnosed as Irritable Bowel Syndrome (IBS) or the stomach flu

What is C. difficile?

C. difficile is an anaerobic, gram positive, spore-forming bacillus

The overpopulating C. difficile bacteria release toxins (Toxin A and Toxin B) that damage / inflame the lining of the intestines.  Causing bloating and severe diarrhea (C. difficile-associated diarrhea / CDAD) with abdominal pain:

•    The toxins destroy the normal colon cells and produce pseudomembranes.   Visualized on colonoscopy as yellowish-white plaques of inflammatory cells on the interior surface of the colon;

•     Can lead to infection of the colon.   Identified as C. difficile colitis or Pseudomembranous colitis, promoting severe inflammation;The toxins destroy the normal colon cells and produce pseudomembranes - which are visualized on colonoscopy as yellowish-white plaques of inflammatory cells on the interior surface of the colon;

•    CDAD is a major cause of morbidity, especially in the elderly.   C. difficile infections have dramatically increased in recent years, with 500,000 cases and ~15,000 deaths annually in the U.S., according to the U.S. Centers for Disease Control & Prevention. A compromised immune system and delayed diagnosis appear to be factors in an elevated risk of death;

•    This infection is adding significantly to hospitalization costs.   Currently over $1 billion/year in the U.S.  C. difficile is acquisitioned in 13% of patients with hospital stays of up to 2 weeks, and 50% in those with hospital stays longer than 4 weeks.

Clostridia bacteria are normally found in small amounts in the small intestine ileum and colon.   It is rarely found in the oropharynx, stomach, or small intestine jejunum