Older adults also often have more than one condition at the same time,
which can impact the ability to fight off infections.
Recurrent hospitalizations and increased length of stay in health care
also increases the risk for acquiring C difficile.
The microbial flora of the intestines is incredibly diverse, with 200 to
1000 different species of microorganisms comprising about 100 trillion bacteria.
When this ecosystem is intact, it helps us digest food, produce vitamins,
and keep our immune systems in balance.
It also provides protection to the intestines from invading microorganisms.
This is called colonization resistance.
Antibiotic therapy plays a central role in the pathogenesis of C Difficile infection.
Particularly clindamycin, third-generation cephalosporins,
penicillins, and fluoroquinolones.
When antibiotics are consumed, the diversity and numbers of microorganism in
the gut is drastically altered and reduces colonization resistance.
Making colonization and disease with C-difficile more likely.
If C difficile is ingested while the gut flora is suppressed,
it can colonize the gut and start producing toxins.
If the immune response to the toxins is high, diarrhea will not develop.
Conversely, if the immune response to the toxins is low,
residents can go on to develop disease.
C difficile resolves when it is treated with antibiotics allowing the immune
system to respond, and normal gut flora to re-establish itself.
Illness associated with C difficile infection can range from mild diarrhea
to potentially fatal pseudomembranous colitis, toxic megacolon, and death.