The impact of antimicrobial resistance on induction, transmission and treatment of Clostridium difficile infection

Abstract

Clostridium difficile infection (CDI) of the gastrointestinal (GI) tract is a potentially life-threatening disease that has surpassed multi-drug-resistant Staphylococcus aureus as the commonest antimicrobial-resistant organism associated with healthcare1. This obligate anaerobic spore-forming Gram-positive bacillus colonises the GI tract and its numbers increase after disruption of the commensal GI microbiota often induced by exposure to antimicrobial agents2. Paradoxically, the disease that may follow its outgrowth necessitates further antimicrobial treatment. Already a major challenge to infection prevention and control strategies, there are indications that C. difficile is developing further resistance to currently used antimicrobial agents.