1. Deadly Diarrhea …and the salvation of stool Teri Brentnall, M.D. Professor, Medicine Gastroenterology

2. Government Calls Conference to Study Deadly Infection A type of bacteria that causes virulent diarrhea has been spreading through hospitals Trouble in the Gut, When Antibiotics Work Too Well A spore-forming, toxin-producing bacterium can flourish in the large intestine when antibiotics kill off the competition. Deadly Germ Is Becoming Wider Threat The bacterium, Clostridium difficile, has become a menace in hospitals and nursing homes.

3. What causes C. diff colitis? C. diff is naturally in the gut, but can also be acquired through stool contamination on surfaces and food Gut bacteria become unbalanced after antibiotics C. diff grows and create toxins

5. C. Diff has become more drug-resistant & more deadly

7. Epidemiology Commonly occurs in patients in hospitals or nursing homes C. diff spores survive cold, hot, or dry surfaces – killed by bleach Per death certificates, 14,000 people died from C. diff last year in the U.S. Some in CDC estimate that the true number may be 30K

9. Treatment Antibiotics 20% of patients relapse Repeated antibiotics

15. Fecal Transplantation: The Power of Poop Becoming more utilized across the nation Requires physician to be “FDA approved” “Stool pills” may become available Saves lives

16. Prevention of C. diff colitis Avoid “casual” antibiotic use Use of probiotics Hand washing Contact your doctor if you get diarrhea after antibiotic use. In hospital—hand washing programs with chlorhexidine not alcohol-based soap Cleaning practices of rooms