C. diff

So if you had to go and say you had a way of approaching a patient that you suspect with C. diff, what's the approach, what's your algorithm in your head? How are you piecing through that?

Well, I think the first things you have to do is, is obviously the most common presentation is gonna be diarrhea.

So that's probably the first ...

I mean, I, that's not always the perfect case, but, like, for the most part, the only way that you can truly, for the most part, prove that a patient has C. diff is you need stool assays to prove it for the most part.

There's other ways that you can go about it, but stool assays is the, is the first thing.

And so they need to have, first off, if I ever sent a, like, full-on solid turd sample to the lab to test it for C. diff, they wouldn't test it.

It needs to be, like, a liquid stool.

Soup.

Yeah.

[laughs] Exactly.

It's gotta be poo soup.

And so you need a liquid stool for them to even test it.

So that's the first thing, and usually you need a patient to have pretty persistent, like, diarrhea, pretty watery.

Can be mucusy or bloody, but it's just m- at least like three or more stools, like liquid, unformed, within a 24-hour period, and it's just kinda consistent.

But on top of that, I need, like, risk factors.

So if I have the diarrhea factor, I have the risk factors, like, and we'll get, probably get into that, but, like, antibiotics recently, and very specific ones.

It can happen with any antibiotics.

I don't wanna go with that, but just for the exams, specific antibiotics are very commonly targeted on your exams.

And the other thing is it couldn't just be not only antibiotics, it could be in, like, people who live in, like, long-term healthcare facilities like nursing homes, or it could be recent hospitalization because there's a pretty high C. diff spore load in, like, hospitals just because of, you know, if you're not ...

It's, these C. diff spores are very resistant, so, like, if you're going and you have a patient, let's say that they, you don't know that they have C. diff, and you actually go, you examine them, and let's just say that they went to the bathroom and then they were touching part of that fecal area, and then they had it on their garments or on themselves, and you go and you examine it, and then you go ahead and you do the hand sanitizer.

That alcohol-based stuff, it can't kill C. diff.

Wow.

So you need things like really, like, good antibacterial soap and water to really allow for that effect.

So that's why it's really important, so the, those kinds of risk factors make me think about it.

Once I've had that kind of trigger to say that this person has risk factors and that diarrhea, then I can send off, like, a stool assay.