James I. Mangels, MA, CLS, MT (ASCP), F(AAM) - Microbiology Consulting Services - Santa Rosa, CA Approved for 3.0 CE Level of Difficulty: Intermediate CAMLT is approved by the California Department of Public Health as a CA CLS Accrediting Agency (#21) Clostridium difficile is an anaerobic, gram-positive, spore-forming bacillus. The species name “difficile” was given to the organism because it was initially difficult to isolate. Subsequently, improved media and improved anaerobic techniques have allowed C. difficile to be more easily isolated. Some strains of C. difficile can be non-toxigenic, non-virulent, and can be part of the normal intestinal flora in about 3% of the population. These patients are asymptomatic, but are carriers of the organism. The toxigenic strains, however, produce a spectrum of gastrointestinal disease ranging from mild diarrhea through moderately severe disease characterized by watery diarrhea, abdominal pain and cramps, nausea, fever, hypotension, sepsis, and even fatal pseudomembranous colitis. Clostridium difficile is recognized as the primary cause of nosocomial (hospital-acquired infection or HAI), infectious diarrhea in the majority of healthcare facilities.
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