Clostridium Difficile

Clostridium difficile is one of the most common species of bacteria that can infect both humans and animals. It is frequently abbreviated as C. difficile or just C. diff. It usually causes liquid diarrhea with several outbursts per day for at least two days. However, there are other possible symptoms such as poor appetite, stomach pain, fever or nausea.

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This pathogen can be present inside the human body without any symptoms at all. It usually starts a number of colon bacterial diseases, more or less severe. The most common is a form of mild diarrhea but it can also trigger inflammation of the colon, known as colitis, which is very serious and can even be lethal.

While most people who suffer from a Clostridium difficile infection will not have any symptoms, the bacterium is still very dangerous. The problem is the infection can suddenly become serious if the immune system is weak, for example during treatment with antibiotics or when interned in a hospital. Infected people can easily spread the disease to others without even being aware of it.

C. difficile is naturally found in most people's bodies, studies have revealed that 66 percent of infants carry it, as well as around 3 percent of adults. It is a lot more common at a young age, decreasing in level at maturity. It lives inside the intestinal tract or the gut.

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The germs usually have no effect on healthy people, who don't develop infections. During antibiotic treatments, some of the good bacteria in the gut are killed, which lets C. difficile spread out of control, causing diarrhea and even more serious issues.

Since C. difficile infections are usually linked with the use of antibiotics, they are the most common in hospitals and other healthcare units. This is because most people in such locations use antibiotics. Elders are more vulnerable and have a higher risk of infection, they also develop more severe symptoms.

In most cases, C. difficile infections are not serious and people recover without any treatment or consequences. Sometimes treatment is needed and the infection can return. In rare cases there can also be complications, even with fatal consequences.

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The usual symptom of a Clostridium difficile infection is mild diarrhea, sometimes moderate outbreaks. It this turns into colitis or other more severe diseases, treatment is mandatory. If ignored, colitis can evolve further into fulminant colitis or other complications that can only be cured by emergency surgery.

The bacteria infect people who suffer from conditions that reduce immunity, as well as during treatment with antibiotics. The most common form of transmission is through feces, when items or surfaces contaminated with them come in contact with the nose or mouth.

Clostridium difficile is a very resilient pathogen. Its spores are very hard to kill and survive for months even in very difficult conditions. They are easily transmitted between hospital patients, or from the medical staff.

Many bacterial diseases are treated with antibiotics. While neutralizing pathogens, the treatment can also kill the micro flora of the colon, which is a resident population of good bacteria. The micro flora helps with digestion and protects the colon from pathogens. Clostridium difficile is more resistant to antibiotics than the good bacteria strains, so it can quickly replace them and start an infection.

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As the bacteria multiply, they release toxins that damage colon cells and cause ulcers to appear, resulting in diarrhea and other symptoms. The same toxins cause a strong colon inflammation. Clostridium difficile infections are easily identified by the presence of a pseudo membrane, which is actually a layer of dead cells and mucus.

What are the risk factors?

The risk is much higher in healthcare clinics and hospitals, where most of the people present use antibiotics and it is very easy for bacteria to spread. People in hospitals are also more likely to suffer from other diseases and have weakened immune systems.

There are many factors that increase the risk of developing a C. difficile infection. Many of them are linked with the use of antibiotics, people who have been taking them for a long time are especially vulnerable. Broad-spectrum antibiotics, designed to kill a wide range of bacteria, as well as treatments that use multiple antibiotics at the same time, also boost the chances of infection. The risk period also extends for some time after the actual treatment ends, while long stays in the hospital can result in infections even if antibiotics were not used.

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As a result, people who spend a considerable time in nursing homes or care facilities are very vulnerable, especially since the risk increases after the age of 65. Having a weak immune system is also an aggravating factor. The causes can be colon diseases, abdominal or gastrointestinal surgery or any other condition that reduces immunity. People who have been infected with C. difficile in the past are also more likely to develop it again.

What are the causes?

As an anaerobic bacterium, C. difficile lives and can reproduce in the absence of oxygen. Many people naturally carry it in their intestines without any problem and it also lives in feces, soil or water.

C. difficile is extremely common in nursing homes, long-term healthcare facilities and hospitals. A much higher than normal proportion of people in such establishments carries the bacteria and the risk of infection is also increased.

The most common transmission method is through feces, it then contaminates various objects or surfaces and even food. A proper hygiene and washing hands regularly is mandatory to reduce the spread. The spores of this species are extremely resilient and can survive for months in harsh conditions.

Million strains of bacteria are naturally present inside the human intestines, many of them helping with immunity and digestion. The antibiotics used against infections kill pathogens but also eliminate some of these good bacteria in the process. This offers C. difficile a good chance to reproduce faster and cause problems.

Any type of antibiotic increases the risk of a C. difficile infection. However, the most harmful varieties seem to be clindamycin, penicillins, fluoroquinolones and cephalosporins.

C. difficile starts to become dangerous once it multiplies in large numbers and becomes established. These bacteria release toxins that inflame tissues and destroy cells, creating inside the colon a layer of cell waste.

It must be said that the C. difficile naturally found inside the intestines of many people can't normally be transmitted to others. This is only possible once toxins start to be released.

What is the treatment?

Even if the infections start due to the use of antibiotics, some antibiotics are also the cure for it. Oral vancomycin or metronidazole are commonly prescribed for a ten day cure but sometimes longer periods of treatment are required.

Fecal bacteriotherapy is an experimental treatment with very promising results in initial tests. In order to repair the bacterial tissues inside the gut, fecal material is transferred from a healthy person to a sick one. This technique allows a new healthy micro biome to develop, replacing the original one that has been destroyed for various reasons.

How to stop the spread of C. difficile?

If you understand how the infection is transmitted, it becomes easier to contain it. You should be especially aware of the factors that increase risk, for example an advanced age, treatment with antibiotics or a long hospital stay.

One of the easiest methods to prevent infection is proper hygiene. Wash your hands as often as possible if you already have a C. difficile infection or after a visit to a healthcare institution. Use antibiotics with care, only when it's really necessary, and only following the advice of a doctor. During a cure with antibiotics, report any suspicious symptoms to your physician. You can also replenish the population of healthy bacteria in your gut by taking probiotics.

Be careful in hospital settings; always ask your doctor and other staff to wash their hands before touching you. If you're already infected, stay in a room separated from other patients to avoid spreading the bacteria. Be careful to clean any surfaces you come in contact with.

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