Properties

Pathogenesis

Clinical findings

Laboratory diagnosis

Treatment & Prevention

Gram-positive rods

Obligate anaerobes

Form spores

Part of flora of gastrointestinal tract; carriage rate higher in hospitalized patients.

Fecal-oral route.

Antibiotics suppress drug-sensitive normal flora, allowing C.difficile to multiply & produce exotoxins A & B:

- exotoxin A: causes outpouring of fluid, resulting in diarrhea.

- exotoxin B: damages colonic mucosa.

Diarrhea:

- nonbloody

- neutrophils found in stool.

Pseudomembranes on colonic mucosa.

Exotoxin B detected in filtrates of stool samples by its cytotoxic effect on cultured cells.

ELISA to detect exotoxins A and B.

Pseudomembranes seen on surface of colon by sigmoidoscopy.

Stop antibiotic – lincomycin / clindamycin.

Give oral vancomycin or metronidazole.