 Welcome back to our meds smarter lecture series where we're taking a smarter approach to preparing future physician Before we get started if you'll take just a quick minute and click that like button and also Subscribe and turn the bell on so that you'll be notified when we post new videos Let's continue on our discussion of the claustridia bacteria with claustridium perforinogens claustridium perforinogens here actually produces an alpha toxin less a thin ace Which is a phospholipase and that causes myonecrosis This is a gas gangrene which is important here And it presents a soft tissue crepitus so you can actually hear kind of gas bubbles popping And the tissue that has gas gangrene and then it also shows hemolysis. So how do we? Come into contact with claustridium perforinogens that can inoculate humans. This is going to have Food that is contaminated with these spores That's cooked, but then what's left standing at a temperature that's not appropriate to Ward off any of these spore bacteria So typically less than 60 degrees Celsius for too long food that has these spores inside of it can germinate And when they germinate they can get a vegetative bacteria Which can then become heat labile Forming an enderotoxin and then food poisoning symptoms about 10 to 12 hours after ingestion of that particular spore But most of the time these symptoms will resolve within about 24 hours if it does migrate into tissues Then claustridium perforinogens can perforate a gangrenous leg And you can actually see in an x-ray the gas bubbles that can form here in various tissues of patients with claustridium perforinogens Finally the last claustridia that we will discuss is claustroides difficile or C diff You'll run across this quite often in the wards as this is a very common nosocomial infection But C diff here produces toxins A and B that you will then damage the intro sites in the in the bowel Both of these toxins can give us a watery type diarrhea that is known as pseudo membranous colitis Often times this is actually secondary to antibiotic use So we have the claustridium difficile in our Bowels that is just part of a normal flora it however is resistant to a lot of antibiotics So when we do use certain oral antibiotics that can kill off a lot of our normal flora of the gut It doesn't kill off our C diff. So that is allowing it to flourish So specifically clindamycin and ampicillin can cause these issues with C diff infections Also, PPI's can be seen as a potential cause of infections here. So a patient comes into your hospital They are sick So we give them a medication like clindamycin or ampicillin to help relieve their bacterial infection that bacterial infection ends up going away But causes C diff infection due to that unregulated growth in the bowel of the claustridium difficile Bacteria, how do we diagnose this? Well first and foremost your patients going to have that watery diarrhea There are two ways for us to test and diagnose a C diff infection outside of the very Distinct smell that the patient's room will likely have To be able to actually diagnose this we can do either PCR or an antigen detection test One of these will have to be shown in the stool for this diagnosis to be made Complications associated with a C diff infection is can include toxic mega colon and then treatment for this is going to be unique Specifically the oral vancomycin Something to note about oral vancomycin is that there is zero percent bioavailability So what that means is if I take in vancomycin orally There is zero percent of that vancomycin that's absorbed and put into my system systemic circulation Therefore anything I take orally of vancomycin will just go through my intestinal tract and excrete out with a bowel movement. This is great. However for a C diff infection C diff is very susceptible to vancomycin so we can give oral vancomycin that can help wipe out C diff infections Other common uses that we do have is metronidazole or phytoxamycin if you do have Cases where we treat it and it goes away, but then it does come back and it's a recurrent case we can Repeat what we just did with vancomycin or metronidazole or phytoxamin or We can do a fecal transplant and what this is actually doing here with this fecal transplant is taking healthy normal feces from a patient and inoculating that into the bowels of the patient that has C diff and helping to introduce back a normal flora of Bacteria there. So one thing to remember here is that claustridioides difficile Causes diarrhea so difficile causes diarrhea if you found this material helpful for your studying Please like and consider subscribing to the channel. Also share this video so that more people can benefit from it like you have