Clostridioides difficile

Clostridioides difficile (C. difficile, formerly known as Clostridium difficile) is a Gram-positive, spore-forming, anaerobic bacteria that can cause severe infections in the human gastrointestinal system. C. difficile is the most common cause of healthcare-associated diarrhea and can lead to life-threatening colitis in severe cases.

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Pseudomembranoese Colitis Endo1

Epidemiology

C. difficile infections (CDIs) are responsible for significant morbidity and mortality, particularly in healthcare settings such as hospitals and long-term care facilities. The incidence of CDI has increased over the past few decades, with elderly patients and those with compromised immune systems being at the highest risk.

Pathogenesis

C. difficile produces two primary toxins, toxin A and toxin B, which cause inflammation and damage to the intestinal mucosa. The bacteria can form spores that are resistant to environmental conditions and are easily transmitted between individuals. CDI typically occurs when the normal gut flora is disrupted, often due to antibiotic use, which allows C. difficile to proliferate and produce toxins.

Clinical manifestations

Symptoms of CDI can range from mild diarrhea to severe colitis, toxic megacolon, and even death. Common symptoms include:

• Watery diarrhea (occurring at least three times per day for two or more days)
• Abdominal pain or cramping
• Fever
• Loss of appetite
• Nausea
• Dehydration

Diagnosis

Diagnosis of CDI typically involves stool testing for the presence of C. difficile toxins or the bacteria itself. Additional tests may include endoscopy or imaging studies, such as abdominal computed tomography (CT) scans, to assess the severity of the infection and potential complications.

Treatment

The primary treatment for CDI includes the discontinuation of the inciting antibiotic (if possible) and the initiation of a targeted antibiotic regimen, such as metronidazole, vancomycin, or fidaxomicin.

Prevention

Preventing the spread of C. difficile involves implementing strict infection control measures, such as hand hygiene, contact precautions, and environmental cleaning. In addition, judicious use of antibiotics is crucial in reducing the risk of CDI.

See also

• Antibiotic-associated diarrhea
• Infection control
• Probiotics
• Pseudomembranous colitis

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