Clostridium Difficile associated diarrhoea CDAD

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Clostridium Difficile associated diarrhoea (CDAD)

• Dr Farah Raza Moosvi
• SHO GPVTS
• Bromley

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Clostridium Difficile

• Anaerobic
• Spore producing
• Toxin producing

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Importance of CDAD

• Environmental spores community reservoir
• Increased incidence in Bromley nearly doubled
  in 2 years
• Elderly patients (25 mortality)
• Nursing Home

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Risk Factors

• Broad Spectrum Antibiotic (BSA)
• Duration of antibiotic use
• PPIs
• Elderly BSA consider probiotic
• Community reservoir infection control
• Prolonged healthcare stay/NH

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Antibiotics responsible

• Clindamycin
• Augmentin
• Cephalosporins
• Quinolones

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Recent Changese.g. at the PRUH
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Primary Prevention

• Prudent antibiotic perscribing
• Reduce use of BSA
• Probiotics
• Handwashing
• Isolation
• Stool MCS

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• Bromley PCT presently working on Clostridium
  Difficile action plan

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References

• DoH/HPA
• Journal of antimicrobial therapy
• BMJ
• Journal watch
• Science daily
• PRUH Microbiology Dept

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• We all need to play our part in help limiting the
  spread of CDAD..lets make our community safer
• Thank You