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Clostridium difficile, commonly referred to as C-Difficile or C-diff, is a bacterium known to disrupt the balanced, normal microbiota of the digestive system. Infections such as MRSA and infections in the skin and bone, are resistant to other drugs and medications and C- diff fall among them in that category. C. Diff is considered a super infection, which is a new infection that develops during the course of treatment from your primary infection. This happens because antibiotics are working to fight your primary infection but the antibiotic is not just killing the bad bacteria but also the good bacteria in your gut. So your gut is lacking good flora and that’s where a secondary infection sweeps in. C-diff produces spores which are released through feces and can live on surfaces for a long time if not cleaned properly and can spread to others quite easily. This paper will quickly explain how C-Diff affects the four general layers of the digestive system, namely the mucosa, submucosa, muscularis externa, and serosa, and an overview of treatment options of vancomycin.
Mucosa
The mucosa, the innermost layer of the digestive system, is made of epithelial cells responsible for nutrient absorption and mucus secretion. C-Diff infection damages this layer, triggering inflammation and compromising nutrient absorption. This disruption not only hampers the body’s ability to obtain essential vitamins and minerals but also compromises the mucosal barrier, exacerbating damage and inflammation.
Submucosa
Beneath the mucosa lies the submucosa, housing blood vessels, nerves, and glands essential for nutrient transport. C-Diff induces inflammation within the submucosa, leading to swelling and disruption of the network of blood vessels necessary for the nutrients to be delivered through the body. This disruption further exacerbates malabsorption issues, contributing to the severity.
Muscularis Externa
C. Diff interferes with the muscularis externa by disrupting its role in peristalsis, the rhythmic contractions that propel food through the gastrointestinal tract. C-Diff infection interferes with these contractions, resulting in abdominal pain, discomfort and irregular bowel movements such as diarrhea and pseudomembranous colitis (severely inflamed colon due to plaque on the colon wall.) The bacterium can also induce spasms or paralysis of intestinal muscles, further impeding food movement and disrupting digestion.
Serosa
The outermost layer of the digestive system, the serosa, provides structural support and protection. While C-Diff primarily affects the inner layers of the digestive tract, an infection severe enough can lead to perforation (a hole) of the intestinal wall, enabling the bacteria to spread to surrounding tissues and organs. This breach in the protective barrier poses life-threatening risks such as peritonitis (inflammation of the inner abdominal wall) and sepsis (infection has released toxins into your bloodstream; blood poisoning.)
Vancomycin Treatment
Vancomycin, a glycopeptide antibiotic, is the key treatment option for C-Diff infections because it’s a bactericidal so its primary goal is to kill the bacteria. By targeting the bacterium’s cell wall compound, vancomycin inhibits cell wall synthesis, effectively blocking the growth and replication of C-Diff ultimately killing the bacteria. But unlike other infections that are treated with vancomycin intravenously(IV), C. Diff can only be treated through oral vancomycin. This mechanism of action helps alleviate symptoms and clears the infection from the body, making vancomycin a cornerstone in managing severe cases of C-Diff infection.
Sources:
Study: Vancomycin should be go-to drug for severe C diff | CIDRAP. (2017, February 6). Www.cidrap.umn.edu. Accessed April 17, 2024
Schubert, A. M., Rogers, M. A. M., Ring, C., Mogle, J., Petrosino, J. P., Young, V. B., Aronoff, D. M., & Schloss, P. D. (2014). Microbiome data distinguish patients with Clostridium difficile infection and non-C. difficile-associated diarrhea from healthy controls. MBio, 5(3), e01021-01014. Accessed April 17, 2024 https://doi.org/10.1128/mBio.01021-14
Karen C., C., & John G., B. (2011). Biology of Clostridium difficile: Implications for Epidemiology and Diagnosis. Annual Review of Microbiology, 65( 1), 501–521. Accessed April 17, 2024 https://doi.org/10.1146/annurev-micro-090110-102824
Burnham, C.-A. D., & Carroll, K. C. (2013). Diagnosis of Clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. Clinical Microbiology Reviews, 26(3), 604–630 Accessed April 17, 2024 https://doi.org/10.1128/CMR.00016-13
Marikta’s essay paper delves into the disruption caused by Clostridium difficile on the digestive system, covering the objective of “describing the four general layers and their functions.” A superinfection, the bacterium spreads through the feces and mouth and is particularly caused by prolonged use of broad-spectrum antibiotics, which disturb normal microbiota. C. difficile inflicts damage to the tissue in the digestive system. The mucosa, crucial for nutrient absorption and mucus secretion, undergoes inflammation and damage due to infection, interfering with nutrient uptake. Beneath it, the submucosa has essential blood vessels, nerves, and glands vital for nutrient transport. Inflammation triggered by C. difficile disrupts these networks, worsening nutrient absorption issues. The muscularis externa, responsible for propelling food via rhythmic contractions, C. difficile results in abdominal discomfort, diarrhea, and irregular bowel movements. As the outermost protective layer, the serosa provides structural support. However, severe C. difficile infection may lead to intestinal wall perforation, facilitating bacterial spread and causing life-threatening complications like peritonitis and sepsis. The glycopeptide antibiotic vancomycin inhibits the growth of bacteria, ultimately leading to their death, and is used to treat severe C. difficile infections. Overall, well done.