Update
8/26/2003
Greetings Everyone,
First let me say I
hope my update fines everyone in good health and good
spirits.
"(Feeling the Love of the Lord I
hope?)"
Sorry that it has taken so long for
update.
Not very good news this
update. Baby John has had some setbacks.
He has had an infection call C:diff
twice.
Which is very infectious and has
had to be quarantined for 10 days ec. time.
No visitors but his
mother.
C.Diff is very common in Hospitals
and Nursing homes.
Baby John had to have another
surgery on his small intestines.
He had some blockage from
scar tissue from the
Diaphragmatic
Hernia surgery.
All went well with the
surgery but Surgeon seems to suggest that he may have to have surgery
again for same reasons.
He has a very serious Urinary track infection.
Baby John is quarantined again and will be
through Sept.2.2003
As you will be able to see Baby John looks
good.
Theses conditions are
setbacks.
Baby John and the Dr. still have much work
ahead of them before he can come home.
I will update when I can. Until then please
Say A Prayer for Baby John and his Mother (Chastity)
We are very Thankful to the Lord for all that he does and all that he is.
We are very Thankful to the Doctors and Nurses at
Children’s
We are very Thankful to
you and to all that care to read Baby John’s Prayer pg. And for all the
prayer that has and will go out for John.
May the Lord Bless
you and Keep you always in his loving care,
Grandma
CLOSTRIDIUM DIFFICILE
Clostridium difficile, or C. difficile (a
gram-positive anaerobic bacterium), is now recognized as the major causative agent of
colitis (inflammation of the colon) and diarrhea that may occur following antibiotic
intake. C. difficile infection
represents one of the most common hospital (nosocomial) infections around the world. In the
The disease involves, initially, alterations of
the beneficial bacteria, which are
normally found in the colon, by antibiotic therapy. The alterations lead
to colonization by C. difficile when this bacterium or its spores are
present in the environment. In hospitals or nursing home facilities
where C. difficile is prevalent and
patients frequently receive antibiotics, C. difficile infection is very
common. In contrast, individuals treated with antibiotics as
outpatients have a much smaller
risk of developing C. difficile infection. Laboratory studies show that
when C. difficile colonize the gut, they release two potent toxins, toxin
A and toxin B, which bind to
certain receptors in the lining of the colon and ultimately cause diarrhea
and inflammation of the large intestine, or colon (colitis). Thus, the
toxins are involved in the pathogenesis, or development of the
disease.
Laboratory
Diagnosis - The laboratory diagnosis of C. difficile infection is primarily related to
the demonstration of C. difficile toxins in the stool of suspected
patients. The detection of C. difficile toxins in the stool can be made by
a laboratory test (cytotoxicity assay) where the toxins can be easily
observed in the microscope. This tissue culture assay is considered the
gold standard because of its high sensitivity and specificity.
Since there is no correlation between
levels of C. difficile toxins in the stool and severity of the disease, the results are reported simply
as "positive" or "negative." However, time is a drawback of this assay
since it requires 24 to 48 hours to read the results.
Over the past few years several rapid tests
that take just a few hours, and which do not require specialized personnel
to run, have been developed (immuno-enzymatic assays) for the detection of
C. difficile toxins in the stool. These tests are commercially available
in the form of diagnostic kits. Although they are relatively less
sensitive and demonstrate lower specificity compared to the laboratory
tests, they are very useful not
only in the every day practice when specialized personnel is not
available, but also in emergency situations and in rapid screening of
patients during spreading of the disease in hospitals.
Therapy - Therapy of C. difficile is directed against
eradication of the microorganism from the colonic microflora. No therapy
is required for asymptomatic carriers. In noncomplicated patients with
mild diarrhea, no fever, and modest lower abdominal pain, discontinuation
of antibiotics (if possible) is often enough to alleviate symptoms and
stop diarrhea. When severe diarrhea is present and in cases of established
colitis, the patients should receive the antibiotics, metronidazole
or vancomycin, for 10 to 14 days. Several clinical trials have
shown that these antibiotics are equally effective in cases of mild to
moderate C. difficile infection and more than 95% of patients respond very well to this
treatment. Diarrhea following treatment with either vancomycin or
metronidazole is expected to improve after 1 to 4 days with complete
resolution within 2 weeks. However, some patients do not respond despite
aggressive medical therapy and require surgical intervention.
Therapy for relapsing C. difficile infection - Although C. difficile infection usually responds well to treatment with metronidazole or vancomycin, approximately 15 to 20% of patients will experience re-appearance of diarrhea and other symptoms weeks or even months after initial therapy has been discontinued. The usual therapy for relapse is to repeat the 10 to 14 day course of either metronidazole or vancomycin and this is successful in most patients. However, a subset of patients continues to relapse whenever antibiotics are discontinued and this represents a therapeutic challenge. Some authorities recommend switching to the alternative antibiotic from the one used initially. A variety of other therapies have also been described for relapsing disease. It is hoped that development of vaccines against C. difficile toxins may someday control the problem of C. difficile infection in hospitals.
