Pathogens
Clostridium difficile

Clostridium difficile

Precautions

Contact/Spore Precautions

Susceptibilities

General Information

Vancomycin (oral)

Metronidazole

Anaerobic spore forming Gram positive bacilli, box-car shaped

Nosocomial > community onset diarrhea usually after taking antibiotics.

Can occur in outbreaks.

Recurrence is very common therefore previous history of C. difficile is a risk factor.

Antacids, especially proton-pump inhibitors, and chemotherapy also increase risk.

Wide range of symptoms possible, and 15% are asymptomatic

Profuse, watery diarrhea

Pseudomembranous colitis or toxic megacolon

Normal colonizer in infants

Discontinue concomitant antibiotics whenever possible.

In refractory cases, stool transplants have been effective.

The lab will only accept liquid (diarrhea) stools, and only once per week.

Do not test patients receiving concomitant laxatives.

Hospitalized patients must remain in contact/spore precautions for the duration of their hospitalization, even if they change rooms.