Curious Clinicians Episode 74 - DIFFerent Babies

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ONLINEABIM MOC Part 2AMAMOCPodcastsCurious Clinicians

Instructions

Thursday, August 17, 2023, 12:00 AM - Monday, August 17, 2026, 11:59 PM

Why are infants less likely to have Clostridium difficile infection?

Adult clinicians are quite familiar with Clostridium (or Clostridioides) difficile infection (CDI). But this infection is remarkably rare in infants. The explanation is both fascinating and has important implications.

Beginning at the beginning, Clostridium difficile was first isolated in 1935 by two microbiologists, Elizabeth O’ Toole and Ivan Hall, who were examining the stool flora of 10 newborn babies. Of these 10, four were colonized with a bacteria that had never been isolated before. It was a spore-forming anaerobic rod that was difficult to culture given its propensity for slow growth. They called it Bacillus Difficilis. All four babies were asymptomatic. But Hall and O’Toole used an inverted version of Koch’s postulates and tested to see what would happen after inoculation of this newfound bacteria into guinea pigs. The animals experienced severe colitis and 16 of the 22 died over the next nine days. The authors rightly noted that this is a pathogenic organism, given how sick the guinea pigs got, but for some reason, the babies were unscathed. They published their report in JAMA Pediatrics.

1. Understand that babies are protected from C. Diff colitis.
2. Examine the results from a confluence of both host and bacterial factors.
3. Discuss how Cdiff colonization may help protect from C. Diff colitis later in life via humoral immunity.

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In order to receive continuing education credit, learners must listen to the 30 minute podcast, pass the post-test (3 questions, 100% required score, unlimited attempts), and complete an evaluation form.

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The planning committee members report having no relevant financial relationships to disclose:

Hannah Abrams 
Tony Breu
Avi Cooper

In support of improving patient care, this activity has been planned and implemented by Curious Clinicians and VCU Health Continuing Education. VCU Health Continuing Education is jointly accredited by the Accreditation Council for Continuing Medical Education (ACCME), the Accreditation Council for Pharmacy Education (ACPE), and the American Nurses Credentialing Center (ANCC), to provide continuing education for the healthcare team.

 

VCU Health Continuing Education designates this enduring material activity for a maximum of 0.50 AMA PRA Category 1 Credits. Physicians should claim only the credit commensurate with the extent of their participation in the activity. 

Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 0.50 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

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AMA PRA Category 1 Credits™ (0.50 hours), ABIM MOC Part 2 (0.50 hours), Non-Physician Attendance (0.50 hours)