Saturday, March 19, 2011

Hospital Infections: C. difficile

When going into the hospital for treatment, most don't think about coming out with a serious disease. The disease caused by the toxins of Clostridium difficile is probed by good bacteria in the intestines being weakened by antibiotics, allowing the spores of C. difficile to evolve, form colonies, and attack the lining of the large intestine. This disease affects approximately two percent of the people that are hospitalized, with favor to the geriatric population.

To test the theory that this is a hospital- obtained bacterium, a research was done on 385 cases of C. difficile from 1991- 2005. Of the 385 cases, 192 of them were obtained from a hospital setting and another 35 was obtained from nursing home. It is more likely to obtain this bacterium in a hospital, but it is also possible to get this strand of bacteria in the community, outside of a medical setting.

When C. difficile is obtained from the community, it tends to not be as serious and affect a younger generation. This is most likely because people in the community have not recently been exposed to antibiotics like those who were hospitalized, therefore the good bacteria in their intestine was not being weakened by antibiotics. C. difficile is becoming more common in both the hospital and community. Antibiotics are being used more frequently and for illness of less importance, so more people are being exposed and affected.

Following the germination of C. difficile, patients will experience very painful stomach cramps, diarrhea, severe flu- like symptoms, and in some cases, deadly inflammation of the colon. Doctors are better able to recognize C. difficile now, making it easier to treat. The CDC references that C. difficile is responsible for at least 5,000 deaths.

Current treatment methods are not as effective as they once were because C. difficile is becoming resistant to the antibiotics used to treat it. Because it is becoming resistant, researchers need to find something more versatile that will treat C. difficile and not act as a typical antibiotic. A very interesting twist is added when it was discovered that a biosensor in the blood of llamas could be beneficial to treat C. difficile.

As mentioned earlier, C. difficile generates two different toxins, TcdA and TcdB. Both of these toxins destroy the intestinal cells by binding to the carbs on their surface and prohibiting adhesion. It has been learned through research that a single- domain cell (sdAb) could break this pattern and impede the damage to the cells of the intestine. Llamas, camels and sharks have a second antibody that is much like a human antibody, but ten times smaller, which allows it to be easily manipulated into something useful. The antibody is called a heavy chain antibody, which is derived from the single domain antibody that researchers are utilizing. Besides their small size and versatility, they are optimal for use because they are low maintenance, but highly efficient.

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