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The lecture C. Difficile Infection (Antibiotics) by John Fisher, MD is from the course Gastrointestinal Infections.
Included Quiz Questions
Which of the following antibiotics is LEAST likely to be associated with antibiotic associated colitis?
- Vancomycin
- Ampicillin
- Amoxicillin
- Clindamycin
- Trimethoprim
A patient has a second relapse of Clostridium difficile colitis due to spore formation. What is the appropriate treatment?
- Pulsed regimen of oral vancomycin
- High dose intravenous vancomycin
- Intravenous metronidazole
- Oral metronidazole
- Oral metronidazole plus rectal vancomycin
How is clostridium difficile transmitted?
- Spores picked up through contact
- C. difficile is not contagious, it is only due to antimicrobial treatment
- Through aspiration of spores
- Through ingestion of contaminated foods
- Typically spread through surgical instrumentation
Which Clostridium difficile toxin is the most potent?
- Tcd B
- Tcd A
- Subunit C
- Binery Toxin
- CDT
How does the Clostridium difficile toxin affect the colonic cells?
- Enters the cytoplasm and glycosylates RhoB protein which disrupts the actin cytoskeleton and kills the cell
- Binds to GM1 ganglioside on the mucosal cell surface and enters the endoplasmic reticulum
- Binds to Rho B protein then creates a pore in the cell wall and allows the active toxin to enter the cytoplasm
- Enters the cytoplasm and increases the production of cyclic AMP which causes ion transport abnormalities
- Enters the cytoplasm and is transported into the mitochondria through RhoB receptors which promotes an inflammatory response and cellular apoptosis
How is a confirmed diagnosis of Clostridium difficile colitis typically made?
- Enzyme immunoassay for 2 stool specimens
- It is simply a clinical diagnosis
- Serum analysis for C. difficile toxin A
- It can only be confirmed by pseudomembrane biopsy
- Stool cultures
Author of lecture C. Difficile Infection (Antibiotics)
John Fisher, MD
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