Question

VIII. A female patient has been suffering from continuous diarrhea for a week. The stool had a metal like smell. The patient is a nurse at an Assisted living home. She felt sick a week ago and her symptoms resembled that of one of her own patients. Her symptoms have been worsening to the point she is very sick and had to take time off. 1. What disease does she have? Name the causative agent. 2. How did she become infected with this microbe? Explain the pathogenesis of this disease. 3. What is the virulence factor and how would you treat this disease? 4. What would you advise the patient to do in the future to avoid such illness in particular in her line of work. (microbiology)the disease is gastrointestinal infectious disease

Answer 1

Hi Answer:

Q. 1. What disease does she have? Name the causative agent.

Answer: According to the symptoms as written in the question description, that she is working as a nurse and have continuous diarrhea from a week and stool had to metal like the smell and these all symptoms are resembling one of her patients. These all facts show that she is suffering from a gastrointestinal infectious disease which causes potentially fatal inflammation of the colon. The causative agent of this disease is bacterium Clostridium difficile and commonly known as C. difficile or C. diff. The infection caused by it is also known as CDI.

The habitat of C. difficile: This bacterium is found all around us in water, air, soil and in the feces of humans and animals. It is observed that many people have this bacterium in their intestine but they don’t have any infection but when the immune system of body or gut microflora become weak due to some illness or use of any specific antibiotic this bacterium start showing its negative effects.

How it spread: C. difficile spread by poor personnel hygienic conditions. The health workers who are dealing with the patient suffering from its infection, the bowel diseases, colorectal cancer have more chances to get an infection. The person whose immune system is being suppressed due to cancer treatment is also prone to get this infection.

2. How did she become infected with this microbe? Explain the pathogenesis of this disease.

Answer: The C. difficile is found everywhere in the environment and it is described in the question description that she is working as a nurse and one of her patients also have same symptoms. It is sure that she got an infection from her patient as it is described above that the medical /health workers who are dealing with infected patients are more prone to the C. difficile infection (CDI).

Disease pathogenesis: C. difficile infection results in the destruction of gut microflora. The C. difficile spread infection by means of two ways (i) endogenous, where infection took place via the carrier strains which are present inside the intestine (ii) Exogenous mode where infection took place from infected individuals, contaminated healthcare personals and from the contaminated environment. It also spread by oral-fecal infection where the resistant spore enters into the body via mouth and reach in the stomach, these spores are resistant to the acidic condition of the stomach. In the small intestine, this spore starts germination and produce the vegetative form of C. difficile. The colonization of the C. difficile occurs in the large intestine. Here it starts multiplying and produces a toxin which damages the intestinal crypts. Bacterium C. difficile produces two type of toxin i.e. toxin A (an enterotoxin) and B (a cytotoxin). Toxin A is known as major toxin whereas the toxin B help in the production of toxin C. Toxin A and B are responsible for the major virulence caused by C. difficile strain which further causes mucosal inflammation and diarrhea.

3. What is the virulence factor and how would you treat this disease?

Answer: This disease is caused by bacterium C. difficile. This bacterium produces two type of toxin i.e. toxin A (an enterotoxin) and B (a cytotoxin). Toxin A and B are responsible for the major virulence factor which further causes mucosal inflammation and diarrhea. Whereas toxin C causes other virulence factors such as CDT binary toxin, fibronectin binding protein FbpA, fimbriae, SlpA S-layer, Cwp84 cysteine protease, and Cwp66 and CwpV adhesions.

Treatment of C. difficile Infection (CDI): The treatment of the CDI depends upon the severity of the infection as well as the type of C. difficile strain which cause infection. The patient having severe CDI is treated with oral vancomycin is given as first-line therapy due to faster symptom resolution and in certain cases, metronidazole is used.

4. What would you advise the patient to do in the future to avoid such illness in particular in her line of work. (microbiology)the disease is gastrointestinal infectious disease

Answer: As this infection is caused due to failure in taking proper hygienic precautions or from the contaminated environments. The patients are advised maintain proper personal hygiene and avoid excessive use of antibiotic so that the gut microflora remain healthy to fight effectively with endogenous C. difficile infection. Secondly, the healthcare professionals also took proper precautions while they are dealing with the CDI patients.