Clostridium Difficile Infection

Clostridium difficile is an anaerobic, gram-positive, spore forming rod-shaped bacillus, spread via the fecal-oral route. The organism was first identified by Hall and O’Toole on 1935 in the stools of newborns,and referred to as Bacillus Difficilis in view of the difficulty in isolation and study. The organism was subsequently renamed Clostridium difficile. The first reported case of toxin-producing Clostridium as a cause of antibiotic associated colitis was in 1978.Risk factors associated with C. difficile are previous antibiotic usage, age greater than 65 years, immuno compromised patients, use of laxatives, proton pump inhibitors or H2 blockers, chemotherapy, renal failure, gastrointestinal surgery, naso-gastric tube placement, mechanical ventilation, and prolonged hospital stay. C. difficile colonizes 3-4% of healthy adults, and 30% of infants aged<12 months. The normal gut flora acts as a colonization barrier that protects against C. difficile. This barrier may be compromised when the gut flora is disturbed by antibiotic therapy. Studies have indicated that 85% of patients with C. difficile infection had received antibiotics within 28 days of onset of symptoms. Almost all antibiotics have been associated with C. difficile, however, the greatest risk is following treatment with Clindamycin, broad-spectrum cephalosporins, and fluoroquinolones.

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Last date updated on April, 2024