Question

A new patient diagnosed with C-diff infection, who has frequent bouts of diarrhea, has

been admitted to the unit.

A. What is the cause of C-diff infection? B. Name one treatment for C-diff. C. According

to the chain of infection, the diarrhea exhibited in a C-diff infection represents which part

of the chain? D. What type of isolation would be initiated for this patient?

4.

A patient has been recently diagnosed with Syphilis. The physician ordered to initiate

Benzanthine Penicillin 2.4 mg/4 mL. What route will be used to administer this

Answer 1

Clostridium difficile or C. diff is a bacteria which enter into the human body through feco-oral route and produce toxins that affect cells of intestinal lining and leads to inflammation and damage and watery diarrhea.

A.The main cause of infection is ingestion of contaminated food and water. The bacteria can stay in air, soil, water, environmental surface and enter into human by unclean hands or through food. Once it is swallowed can leads to infection. Other causes includes opportunistic infections, long term stay in hospital, long term use of antibiotics and serious bowel disease or surgery. Some people carry C diff bacteria normally in there intestine without any symptoms or spreading to others. during long term use of antibiotics, the normal flora in the intestine can be decreased and the c.diff will grow rapidly may leads to infection. Immunosuppresed patients who stay long term in hospital have the chance of geting infection from other patients or hospital equipment.

B. 1. Antibiotic therapy

Metronidazole 500 mg per oral 3 times a day for 10–14 days is the drug of choice for the initial episode of mild-to-moderate C. diff infection and Vancomycin 125 mg per oral 4 times a day for 10–14 days is the drug of choice for an initial episode of severe C. diff infection.

2. Probiotic therapy

3. Fecal microbiota transplant

4. Colectomy

C. The chain of infection includes six steps.In C diff infection, they are

Infectious agent; C diff

Reservoir; bowel of infected person

Portals of exit; The diarrhea through which microorganism get into the environment.

Mode of transmission; Faecal oral route and direct or indirect contact.

Portals of entry: Oral

Susceptible host; patients with long term hospital stay, immunosuppresed patients, children.

The diarrhea experienced by the infected person or reservoir is comes under portal of exit of the chain of infection.

D. The patient should be kept under contact isolation or contact precaution when they experience diarrhea.

4. Benzanthine Penicillin 2.4 mg/4 mL for Syphilis is a long acting antibiotic. It should be given only intramuscular route. ( divide to half and give 2mL in each buttocks)