Bacteria Clostridium difficile
Bacteria Clostridium diffifile lives in the body of every human being. Has a tendency to intensive reproduction, because of what it becomes dangerous, as it acquires pathogenic properties and causes certain diseases. Refers to obligate anaerobes and can exist without oxygen. Involved in the work of critical processes, such as protein splitting, stimulation and toning of the intestinal walls.
What is Clostridium Difficile?
The word "clostridium" in Russian means "spindle".A similar name for microbes is due to the peculiarity of swelling in the middle of sporulation. Still bacteria are able to acquire the shape of a spindle. They are divided into four types, this:
- Clostridium botulinum, is the causative agent of botulism;
- Clostridium tetanum, promotes the appearance of tetanus;
- Clostridium perfrigence, affects the appearance of anaerobic infection;
- Clostridium diffifile, causes pseudomembrane colitis.
Clostridium has a rod-shaped shape. Can be arranged in chains and in pairs. It is sufficiently mobile. In conditions of complete absence of oxygen, it begins to multiply intensively. Microbes create spores, which gives them resistance to antibiotics, heating and various drugs for disinfection. The central dispute is in the form of a spindle, and the one that is located terminally is the shape of the drumsticks.
Clostridium diffifile causes diarrhea from antibiotics. Usually lives in the intestinal environment. With good health, beneficial microorganisms restrain the growth of this bacterium. After using antibiotics, beneficial bacteria become less, and the number of Clostridium increases, which can provoke the appearance of colitis, cause a serious pathology and even death of a person. This is especially true of elderly and weakened patients.
All varieties of clostridia form toxins that cause the appearance of a certain pathology. As a result of its reproduction, it produces toxin A and B Clostridium difftyle. The first is called enterotoxin, and the second is called cytotoxin. They are the cause of diarrhea and colitis in many people.
Clostridium diffifile usually lives in hospitals and nursing homes. Can be anywhere: on the floor, window sills, bedside tables, in bed and toilets. Disputes of the microorganism unobstructedly fall into the hands when in contact with the contaminated surface. Predominantly spread by fecal-oral route.
Once the spores have penetrated the body, they easily pass through the stomach and remain in the intestines. In the medium of the small intestine they are transformed into a vegetative form and actively begin to multiply. In the large intestine, the bacterium settles in the intestinal folds and begins to release toxins A and B, resulting in severe inflammation of the intestinal environment, which causes the disintegration of the products of decay and mucus. The formation of pseudomembranes occurs. Toxin A begins to attract white blood cells, at the same time, toxin B is involved in the destructive effects of epithelial cells. These processes provoke the appearance of colitis, watery stools and the appearance of pseudomembranes.
Basically, all pathologies involving Klostridium difffile occur after treatment with antibiotics, as well as after surgery. The elderly people after 60 years old and those who are on long-term inpatient treatment, as well as patients taking immunosuppressive medicines, are especially vulnerable to microorganisms.
Clostridium difficile provokes mild or moderate diarrhea and minor stomach cramps. But in exceptional cases, the disease passes into a more severe form of colitis. What causes such symptoms as:
- watery stools;
- pain in the abdomen;
- increased body temperature;
In 3% of cases, patients develop a severe form of the disease. Of these, 30-85% die. In 20-25% of patients, the disease can occur repeatedly. Relapses of pathology are due to those bacteria that remained in the large intestine after therapy or because of a new infection of Clostridium Difficile. Disease can suffer children, especially those who are weakened.
Diseases caused by the bacterium
Clostridium difficile in one third of cases provokes diarrhea associated with taking antibiotics. In other situations, the appearance of the disease is affected by other bacteria. Most often, the disease occurs in hospitals. Children practically do not suffer from this.
An antibiotic-associated diarrhea( AMA) can have different stages of development, from mild intestinal disorder down to a severe form of enterocolitis, which is called pseudomembranous colitis. The cause of this pathology is an infection caused by Clostridium Difficile, which appears in a number of cases because of the use of antibiotic therapy.
Calling diarrhea or pseudomembranous colitis is capable of even a single administration of an antibiotic with a broad spectrum of action. Moreover, the appearance of the disease does not depend on the dosage and mode of administration of the drug.
Clostridium diffifile: symptoms of infection
Clostridiosis caused by Clostridium difficile can occur in the following forms:
- asymptomatic infection;
- mild diarrhea;
- is a severe form of the disease that has passed into pseudomembranous colitis.
AAD occurs in patients who underwent a course of long-term therapy - more than four weeks in a hospital. Clostridia in the intestinal environment acquire a certain resistance to drugs. When this pathology occurs, there is soreness in the peri-pooch zone, which subsequently affects the entire abdomen. The patient's chair becomes more frequent, but overall the state of health remains satisfactory.
Pseudomembranous colitis caused by clostridium difficile, symptoms is more severe. Dysbacteriosis appears in patients, and the activity of Clostridium difficile prevails. The bacterium colonizes the intestinal mucosa and produces a cytotoxin and an enterotoxin. The inflammatory process of the mucous membrane begins with the formation of pseudomembranes. In the absence of timely treatment, the disease progresses and gives more severe complications. There is a perforation of the intestinal wall, which causes peritonitis. In some cases, the disease leads to death.
Similar disease is most susceptible to cancer patients, elderly people and patients who underwent surgery. The development of pathology is accompanied by fever, pain in the abdomen and head, flatulence, eructation, vomiting. There are other symptoms of intoxication of the body. Patients lose weight, some have anorexia, moral depression, depression. There is also cachexia, attempts, tenesmus, diarrhea with putrefactive odor and fibrin overlay up to 20 times a day.
When poisoning with toxins, necrotic enteritis can develop. In this case, on the walls of the intestine, erosions and ulcers, foci of necrosis are formed. The body temperature rises. There is a chill. Dyspepsia is observed, the stool becomes liquid, with an admixture of blood. Diagnosed hepatosplenomegaly, paresis of the intestines, accompanied by bloating. Possible intestinal bleeding, perforation of ulcers, as well as thrombosis of venules and arterioles.
Often cause food poisoning of clostridia, including Clostridium diffifile. The clinical symptoms of this disease manifest themselves in the form of poisoning. Typically, it is fever, abdominal pain, diarrhea, loss of appetite, indigestion. With this disease all forms of dyspeptic and intoxication symptoms are manifested. Patients become irritable, lethargic and restless. Negative symptoms last about 4 days and gradually subside.
The main feature of the infection are relapses, which are manifested in 25% of cases. The cause of their occurrence are spores located in the intestinal environment. It is impossible to exclude cases of repeated infection. As a rule, immediately after the therapy, recovery comes, but for 2-28 days a relapse may occur, similar in its symptoms with the initial manifestation of the disease.
When Clostridium diffusile is detected in the body, treatment should be started immediately. The causes of this infection are the following factors:
- bad ecology;
- stress, depression, neuroses;
- long-term therapy with hormones and antibiotics;
- dysfunction of the central nervous system;
- prematurity in children;
- insomnia, transformed into a chronic form of development;
- respiratory diseases;
- pathogens of infections living in hospital walls;
These causes weaken the body and promote the reproduction of Klostridium difftyle. Treatment of ailment should only take place after a thorough diagnosis of the patient.
Diagnosis of the disease is based on the detection of symptoms of the pathology and the causes of its occurrence. Anamnesis is taken into account, as well as epidemiological factors. Pay attention to the clinical manifestations of the disease. To establish the diagnosis, use instrumental and laboratory techniques.
The analysis of a feces on Klostridium diffifile is made. In the laboratory, Gram-positive rods and their spores are determined. At a microscopic examination, the biomaterial is sown in a special way and on the basis of this, colonies of pathogenic microorganisms are determined. Special preparation for delivery of such analysis is not needed. The number of clostridia is determined by the gram smear. After that, the species of the bacterium is identified. Cal on Clostridium difficile is examined in a bacteriological laboratory.
When diagnosing a disease, a biological test is performed on white mice, which determines the stage of intoxication of the body, detects the toxin and helps to determine the methods of treating the disease. When diagnosing a disease, an antigen test is done in special immunological laboratories.
In special cases, express diagnostics are assigned, helping to determine the presence of enterotoxin in feces. A biopsy of the intestinal organ is performed, which allows to know about the location of the inflammatory foci.
Serodiagnostics allows detecting the presence of toxin in the RNGA.It is determined together with an anti- diagnostic diagnostic. Observe the reaction, which occurs as a result of counter immunoelectrophoresis.
Instrumental diagnostics is nothing more than the radiography of the intestinal organ, which allows to determine where the gas in the tissues of the human body has accumulated.
The most accurate is the tomographic and the endoscopic examination. It shows the inflammatory process, as well as the formation of pseudomembranes.
Increased activity of clostridia in infants indicates the presence of dysbiosis. In an infant with this pathology, bloating, a decrease in appetite, regurgitation can be observed. Sometimes disturbed sleep disturbance and irregular stools. The number of bacteria in infants should not be more than 103-104 cfu / g. Excess of the indicator is considered a pathology, which must be treated.
If the content of clostridia is normal for the analysis of dysbacteriosis, it means that the intestine works stably. When increasing the number of pathogenic bacteria should be treated intestines.
It is possible to conduct a study on Clostridium Diffiffile in Invitro. There is an analysis of about 1200 rubles. On its basis, most often, the necessary medical procedures are prescribed.
How does the disease manifest in children?
Bacteria Clostridium diffifile rarely affects newborn babies and the crumbs of the first year of life. This is due to the fact that the mother's milk contains special antibodies that are effective against clostridia.
When antibiotic-associated diarrhea occurs in childhood, all the same symptoms occur as in adults. Enterocolitis and mild colitis in children occurs without intoncication and fever. Patients may be concerned about the abdominal pain that occurs with the method of palpation in the area.
Sometimes there is an increase in the stool, which provokes diarrhea, which leads to water-electrolyte malfunctions in the body.
The bacterium can cause recurring recurrent forms of clostridiosis accompanied by colitis. This occurs when the disease is not healed to the end. In this case, clostridiosis occurs after 7-14 days after discontinuation of treatment.
Pseudomembranous colitis develops in an acute form in childhood. At the initial stage of the disease there is no appetite. There is a fever, belching and spasms in the abdomen. There is an intoxication of the body, diarrhea and bloating. When the palpation of the abdomen is observed soreness. The chair becomes more frequent. Blood and mucus appear in it. There may be scraps of fibrinous overlays. If diarrhea is frequent, then there is an excoxic effect, accompanied by circulatory failure. In isolated cases there was a collapse.
The development of pseudomembranous colitis is sometimes exacerbated by perforation, bleeding, and the onset of peritonitis. In such cases, children should be watched not only by a pediatrician, but also by a surgeon.
Disease caused by Clostridium diffifile: treatment methods
Clostridiosis is treated only in a hospital. When there is intoxication, as well as dyspeptic disorders, gastric lavage is prescribed and the bowels are cleared with an enema. On the first day, a water-hungry diet is recommended.
Antibiotics-macrolits are used among medicines. Clostridia are sensitive to them. Among such drugs, Clarithromycin and Azithromycin are most often used. Toxin Clostridium difficile( the symptoms and treatment are set individually by the doctor, relying on the patient's condition), medicine can remove cephalosporins, among which are "Cefazolin" and "Ceftriaxone."Often antibiotics of the penicillin series are used to fight pathogenic bacteria, these are "Vancomycin", "Amoxiclav".Metronidazole is also used.
To restore the microflora of the intestinal environment, doctors prescribe probiotics and prebiotics. The most popular are Hilak Fort, Acipol, Laktofiltrum, Bifiform, Enterol, Linex, Enterol.
To remove intoxication, intravenously injected "Reopoliglyukin".If necessary, prescribe antihistamines and corticosteroids.
Symptomatic treatment with enterosorbents, hepatoprotectors, vitamins, nootropics, cardiac glycosides, as well as antipyretic drugs.
It is believed that ongoing therapy is effective if:
- decreases the frequency of stool;
- the consistency of the stool becomes thicker;
- the general condition improves;
- , there have been positive changes in clinical and laboratory analyzes;
- does not develop the disease.
If the antibacterial therapy does not go through the symptoms of Clostridium Difficile, the treatment is adjusted.
Sometimes colitis, triggered by Clostridium difficile, is treated surgically. Usually this occurs with perforation of the colon and when there is an inflammatory process with the appearance of a toxic megacolon, and there is also an intestinal obstruction. The operation is done only if adequate conservative treatment has not yielded results.
Can Clostridium difficile be cured?
Infection Clostridium diffifile manifests itself in varying degrees of severity. Has a certain nature of the course and degree of complications.
When the disease is not started and has a mild or moderate severity, the disease is cured 100%.The fever disappears for 1-2 days, and diarrhea stops on the 4th-7th day. With intestinal obstruction, renal failure and pseudomembranous colitis, the situation becomes heavier.
Analysis on Clostridium difficile allows timely to prevent the development of the disease, and to get rid of pathology timely preventive measures will help, which are manifested in:
- compliance with personal hygiene rules;
- washing products;
- heat treatment of food products;
- increased immunity;
- stabilization of intestinal microflora;
- timely detection of infected individuals;
- application of antibacterial therapy.
Pathogenic microorganisms are resistant to ammonia, but die from exposure to sodium hypochlorite, ethylene oxide-containing substances, and also when treated with alkaline glutaraldehyde. When infecting Clostridium Difficle, it is necessary to thoroughly clean all surfaces with these means, in order to destroy bacterial spores of the microbe. Bacteria do not die when treated with alcohol, but washing hands with soap can prevent the occurrence of pathology.