Clostridium Difficile - Essay Example

The role of CDI in antibiotic-associated diarrhea was recognized in 1970s. In 2000, the emergence of a drug-resistant hypervirulent strain was documented. This strain was associated with severe and recurrent CDI. Between 2000 and 2005, the CDI cases almost doubled, of which majority were older adults (Kee 2011). CDI is characterized by at least three unformed feces, within a 24-hour period, with C. difficile (McCollum and Rodriguez 2012). The presence of infection is examined through histopathologic or endoscopic tests.

CDI has been linked to approximately 20% of all cases of antibiotic-associated diarrhea in humans (Carman et al. 2011). From being associated with simple to severe diarrhea, C. difficile is now regarded as the principal cause of various diseases, including sepsis, fulminant colitis, multiorgan failure, toxic megacolon, and even death (Ananthakrishnan and Binion 2010). History and Epidemiology Staphylococcus aureus was commonly linked to antibiotic-associated diarrhea, but in 1974, the cases of clindamycin-associated pseudomembranus colitis were found not caused by S.

aureus (Bartlett 2008). These cases were later associated with C. difficile when the link between CDI and antibiotic therapy was elucidated. CDI became more common and severe since the year 2000. From a common cause of nuisance, it evolved into a principal nosocomial cause of mortality and morbidity (McCollum and Rodriguez 2012). . This percentage increases with age, making the elderly more prone to CDI than the young adults. Older adults may have 10% to 20% colonization rates, depending on the length and frequency of exposure to antibiotic treatments and to C.

difficile (Wilcox 2003). Although the vegetative forms of the bacillus die upon exposure to air, its spores may last for months and even years. Hospitals are the major source of C. difficile spores. The bacillus can also be found in farmyards and domestic animals like dogs, cows, cats, horses, and pigs. In developed countries, hospital-acquired diarrhea is likely associated with C. difficile than any other bacteria (Wilcox 2003). In England and Wales, about 18,000 laboratory cases of C. difficile are reported annually (Wilcox 2003).

More than 80% of these cases involved patients with ages of over 65 years (Wilcox 2003). The elderly patients tend to acquire severe CDI, though increasing age is not a risk factor for the extent of infection severity. These trends were also observed in the U.S. In fact, the economic cost of CDI cases in the U.S. range from $436 million to $3 billion in a year (Ananthakrishnan and Binion 2010). Clinical and Pathological Features It is often difficult to differentiate the clinical and pathological characteristics of the disease caused by C.

difficile from those of other intestinal diseases, such as Crohn’s disease, ulcerative colitis, and chronic inflammatory bowel disease (Knoop et al. 1993). The symptoms may manifest as early as one to two days after an antimicrobial therapy and as late as two to ten weeks after the therapy. C. difficile-associated disease could also occur after a single