Clostridium Difficle Infection In Health-Care Workers Essay

According to Bouza (2005), clostridia Difficile is a bacillus that is gee positive and makes spores. Its main mode of distri plainlyion is the environs whereby it excessively colonizes 3-5% of each(prenominal) healthy adults with verboten ca apply any symptoms that coffin nail be noticed. At infancy, clostridia difficile colonizes between 2% and 70%, but the runs decrease with promotional material in age and falling to about 6% when the infant grows to both years. Above the age of two, the rate of clostridia difficile is ofttimes similar to that of an adult, close to 3% (APIC, 2008). The strains responsible for the production of clostridia difficile ar characterized by their magnate in the production of both toxins A and B. The most common and un visualiseled symptom of CDI is diarrhea that is not always bloody, but stinker sphere from the comfortable and unformed stools to the watery and mucoid stools. Other outstanding symptoms embroil abdominal pains and fever and cramping in others.Clostridium difficile spores ar extremely resistant to destruction by most of the environmental agents and conditions. Their resistance butt end go as far as resisting some of the chemicals apply in dis transmittance (Zanotti-Cavazzoni, 165). Therefore, this gives clostridia difficile the ability to survive for months or longer in the environment and nevertheless in health do by facilities and the surrounding community. Mainly, the spread of clostridium difficile is with the transfer of spores from a contaminated environment to the unhurried, or perhaps by actor of the hands of health cautiousness givers who do not follow fitting hygiene and gloving practices. The only proper secure pulsation that arouse be adopted is the thorough discontagion and cleanup position of the patient ofs environment and besides through the physical removal of the spores.In recent decades, there has been a recorded attach in the number of reported rates of clostridiu m difficile-associated disease (CDAD). There has too been a recording in the increase in the number of outbreaks accompanied by prankish disease and also an increase in mortality. The increase in CDAD is mainly characterized by the undermentioned changes in the use of antibiotics, a change in contagion control practices or the emergence of new strains of clostridium difficile that train change magnitude sourness or antimicrobial. It is also important to comprehend the life pedal of clostridium difficile in wander to understand how to control it and if possible, impede it. Its life cycle begins in the spore form whereby they are because they are resistant to heat, antibiotics or even acid.In a hospital setting, clostridium difficile can be comp scrape up in bedding, medical equipment, and furniture and on the handlegivers. Upon ingestion, the spores pass through to the intestines whereby they arise and subsequently colonize the colon. Studies have indicated that this bac terium colonized about 21% of patients who are in the process of receiving antibiotics and at the same time admitted to a general hospital. Through the release of both toxins A and B, clostridium difficile later induces diarrhea and colitis. However, the major fortune factors associated with clostridium difficile are advancement in age, hospitalization, and antimicrobials.There are two major reservoirs of clostridium difficile in the healthcare setting, which are humans (asymptomatic and symptomatic) and inanimate objects (medical equipment and furniture). The level of environmental contamination depends mainly on the severity of the disease of the patient. However the asymptomatic colonized patients should be regarded as the potential primary source of the contamination.Clostridium difficile infection is to a greater extent rampant among the elderly in the society. The main reasons for this are not fully, but it can be attributed to the fact that the elderly patients have a much less effective barrier to infection. The grandness of having age as a risk factor is characterized by the age distribution in science lab reports as was received by CDSC during the research period of 1990-1992. Results showed that there was a bias for adults over the age of 65 and they were more supersensitive to having severe looks of clostridium difficile infections. There have also been suggestions that clostridium difficile is endemical in facilities that are considered long-stay for the elderly. However, other studies indicate that the difference in the endemic nature of clostridium difficile may be as a result of case mix whereby patients are from other facilities whereby the infection rate was high. Also, clostridium difficile is endemic in many of the long-stay facilities because the elderly tend to stay longer in the acute wards than the other younger generations. Therefore, their increased risk of infection is attributed to the increased exposure to antibiotics and no socomial pathogens.There are several patient care activities that provide a rife opportunity for the fecal-oral transmission of clostridium difficile (CDC). such(prenominal) activities embroil sharing of electronic thermometers that have been used for measuring rectal temperatures, oral care or suctioning whereby the hands or equipment have been contaminated, presidentship of contaminated food, medication or with contaminated hands and emergency procedures want intubation. Other factors like poor hand hygiene, improper environmental and equipment killing and disinfection have also been reported as a cause for infection and cattle ranch of clostridium difficile. It has been rubber stamped that the environment is the major medium of spreading for clostridium difficile whereby it has been spread so widely that that it is impossible to point out a single location that has not been contaminated. However, the environment of the infected patients is rifest with clostridium difficile, for instance, the toilets, floors, sinks and linen paper. Despite disinfection, clostridium difficile spores are found to exist longer than fivesome months.Prevention and control of clostridium difficile is the responsibility of every individual who is awake of its existence. Therefore, hold backion measures must be endorsed by everyone, and especially in care giving facilities whereby individuals are more likely to spread the infection. Standard precautions adduce to those practices at bat that are applied to every person no matter of their affirm or perceived infectious status. Standard precautions are the former line in the war against clostridium difficile. They divine service control the rate of infection from person to person, even in the most prolific risk scenarios. They include hand hygiene in the beginning and after extend to with the patient, the good use as well as disposal of sharps, the use of cautionary equipment and the processing of reusable medical equ ipment. The proper handling of linen, safety in the direction of waste as well as aseptic non- assemble technique should also be in the cadence precautions to be implemented in hospital facilities.However, when the first line of defense does not seem to work efficiently, there should be a backup plan in place. Thus, when standard precautions do not seem to do the job, transmission based precautions should be implemented. These are additional work practices for individually identifiable situations that are stick in place to interrupt the transmission of clostridium difficile. These precautions are accommodate to specific infections and their mode of transmission. They include continued implementation of standard precautions, having patient commit equipment, proper handling of equipment, enhanced cleaning and disinfection of the patients environment and the restriction of patients within the facilities.Since healthcare settings differ greatly in terms of their day-to-day functio ning, it is hard to come up with a management proposal that would fit all facilities. Therefore, all healthcare facilities should conduct infection prevention risk assessment on a regular al-Qaida alongside adoption of detailed protocols and processes for infection control. In acute care setting, personal protective equipment should be provided for nurses and visitors outside the room of a patient who has confirmed clostridium difficile infection. Healthcare givers should use gloves and gowns in order to prevent further spread of infection. Conducting effective hand hygiene is necessary for hold in the spread of clostridium difficile. They should be performed frequently and with the following considerations should be performed using the Four Moments of Hand Hygiene, should be performed at the point-of-care using a consecrate staff sink or the use of hand wipes that have been impregnated with antimicrobials or alcohol and soap.In acute care setting, especially where the elderly ar e residing proper care has to be considered generally because they are more susceptible to infection (Rupnik, 2007). One such measure of preventing clostridium difficile infection is placing the suspect or confirmed patients with CDI in a confined room that has dedicated toilets, sinks and personal equipment. Moreover, there is little need for special treatment for linen in an acute setting for both confirmed and suspected patients. linen for symptomatic and asymptomatic patients should be in the same way. The soiled linen should be carefully. For example, it should be placed in a no-touch receptacle in order to avoid contamination of both the environment and the persons around.In cases of outbreaks, routine infection control measures are of grave importance in order to prevent the spread of the clostridium difficile infection to patients who have not yet been affected. The antibiotic policies have to be monitored as well as their compliance in order to successfully control the sp read of infection. Hand washing procedures should be followed to the latter by any person who is in contact with infected patients such as doctors, nurses, paramedical staff and students. Nurses present challenges in combating clostridium difficile outbreaks especially because of the necessity to create a homely environment for the patients. This means that they have to eer check in with the patients and therefore they become constantly at risk of infection themselves in proper precaution is not taken.For patients in the elderly acute care wards, the surroundings are also tailored to ensure a comfortable stay in the hospital. Therefore, their soft furnishings and carpeted floors provide a challenge in cases of outbreaks. For instances like this, tour of duty methods of combating the spread of clostridium difficile have to be implemented. One such measure that should be used during cleaning is steam. Although the heat does not kill the pathogen, it helps in the containment of its s pread. endurings are also susceptible to contracting infection from the care devices used in the hospital. Such devices include electronic thermometers or glucose measuring devices. These devices are in constant use and may be used by a variety of patients. These devices are with pathogens derived from body fluids. Thus it is important to have measures in place to sterilize these devices especially more thoroughly in times of outbreaks.Another piece of communal apparatus used in wards is the linen, clothing, uniforms, lab coats and isolation gowns. Because clostridium difficile is commonly in the environment and can last for more than five months, these pieces of clothing are always in contact and possible contaminations are likely (Dubberke, 17). However indirect contact of such clothing comes from bedpans, toilets and sinks of patients who are either suspected or confirmed to be infected. The presence of soiled linen is also an area of importance that should be looked into carefu lly. Because bed linen is in hospitals and wards, they should be cleaned and sanitized before they can be issued to a different patient. In order to help combat the spread of clostridium difficile, the CDC has come up with the Spaulding classification system, which identifies trey risk levels that are associated with surgical and medical instruments (Michel, 1095). These levels are critical, semi-critical and noncritical.Critical items include needles, indwelling urinary catheters and intravenous catheters. These are the items that normally enter the unfertilized tissue, the vascular tissue or through which blood flows. Based on one of the accepted sterilization procedures, the equipment has to be sterile before cunning any tissue. Semi-critical items include thermometers, electric razors and podiatry equipment and they are as those that touch mucous or skin which is not intact. They require meticulous cleaning and thereafter followed by high-level disinfection. Disinfection is d one using a chemo autoclave agent that is approved by the FDA.In conclusion, clostridium difficile has been on the rise in recent decades and it is only through proper prevention and control measures that it can be. Since it can live in an environment in spore form for up to five months, it poses a challenge in terms of containment. On the other hand, the elderly are more susceptible to clostridium difficile primarily because of their low immunity and their prolonged stay in hospitals. However, with proper care, chances of outbreaks can be kept at a minimum and more lives can be through prevention instead of cures.ReferencesDelme, Michel. Clostridium Difficle Infection In Health- tending Workers.The Lancet334.8671 (1989) 1095. Print.Dubberke, Erik. Strategies for prevention of Clostridium difficile infection.Journal of Hospital Medicine7.S3 (2012) S14-S17. Print.Patient Cloth Chairs and Clostridium difficile Outbreak.American Journal of Infection Control37.5 (2009) E102-E103. Print .Rupnik, Maja. diddle book Clostridium difficile organism, disease, control & prevention. s.l. Organizing committee ICDS, 2007. Print.Zanotti-Cavazzoni, S.l.. Analysis of an outbreak of Clostridium difficile infection controlled with enhanced infection control measures.Yearbook of Critical Care Medicine2010 (2010) 164-166. Print.clostridium difficle.Centers for Disease Control and Prevention. Centers for Disease Control and Prevention, 1 Mar. 2013. Web.30 Apr. 2014. http//www.cdc.gov/HAI/organisms/cdiff/Cdiff_infect.htmlSource document