Clostridium difficileInfection: Epidemiology, Pathogenesis, Risk Factors, and Therapeutic Options

Abstract

The incidence and mortality rate ofClostridium difficileinfection have increased remarkably in both hospital and community settings during the last two decades. The growth of infection may be caused by multiple factors including inappropriate antibiotic usage, poor standards of environmental cleanliness, changes in infection control practices, large outbreaks ofC. difficileinfection in hospitals, alteration of circulating strains ofC. difficile, and spread of hypervirulent strains. Detection of high-risk populations could be helpful for prompt diagnosis and consequent treatment of patients suffering fromC. difficileinfection. Metronidazole and oral vancomycin are recommended antibiotics for the treatment of initial infection. Current treatments forC. difficileinfection consist of supportive care, discontinuing the unnecessary antibiotic, and specific antimicrobial therapy. Moreover, novel approaches include fidaxomicin therapy, monoclonal antibodies, and fecal microbiota transplantation mediated therapy. Fecal microbiota transplantation has shown relevant efficacy to overcomeC. difficileinfection and reduce its recurrence.