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What kind of bacteria is C diff?
spore forming gram (+) anaerobic bacillus
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Which 2 classes of antbx are most assoc w/ C. diff?
clindamycin and fluroquinolones
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What are risk factors?
age >65 y/o, IBD, immunocompromised, PPIs, recent GI surgery, ileus, antiperistaltic meds, stay in ICU/long term care
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Can you kill the spores?
resistant to high heat, ETOH hand sanitizers, UV light, and cleaning chemicals
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What are usual initial sx?
watery diarrea, nausea, fever, lower abd pain/cramping. +/- mucus in stool, usually no blood
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How to dx?
gold std: cell culture cytotoxic assay. Other: enzyme immunoassay, PCR
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how to treat initial episode for mild-moderate?
Metronidazole 500 mg PO TID 10-14 days
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how to treat initial episode for severe?
Vancomycin 125 mg QID PO 10-14 d. If hypotension/shock/megacolon, both!
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How to treat a 1st recurrence? 2nd?
- 1st: same as initial episode
- 2nd: Vanco
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How is C diff usually transferred from person to person?
fecal-oral or thru fomites
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What are S&S of fulminant/pseudomembranous colitis?
high volume, foul smelling diarrhea (15-30 qd), may be bloody,leukocytosis, fever, hypoalbuminenmia, hypotension, rising Creatinine
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Which drug for tx is associated w/ neurotoxicity and hence shouldn't be used for recurrent recurrences?
metronidazole (Flagyl)
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