Document Detail

Important clinical advances in the understanding of Clostridium difficile infection.
MedLine Citation:
PMID:  23207596     Owner:  NLM     Status:  In-Data-Review    
PURPOSE OF REVIEW: Clostridium difficile remains an important cause of infectious colitis, particularly in healthcare facilities. This review summarizes recent advances in the epidemiology, diagnosis, and treatment of this endemic pathogen.
RECENT FINDINGS: C. difficile infection (CDI) hospitalizations and mortality rates have increased over the last decade. The BI/NAP1/027 strain has been responsible for epidemics with increased severity and mortality and is now endemic in many settings, particularly North America. Concurrent antibiotics have now been shown to decrease the cure rates for anti-C. difficile therapy and increase the risk of recurrence. Although studies implicate proton pump inhibitors as a risk for CDI, the magnitude of and the biological basis for that risk remain unclear. Molecular diagnostic techniques are rapid and sensitive but highlight the importance of using appropriate clinical testing criteria. Fidaxomicin is a promising new therapy associated with decreased recurrence; infections due to BI strains, however, are associated with inferior outcomes regardless of the treatment agent. Fecal transplantation continues to have impressive success rates for patients with recurrent CDI, and a new colon-sparing surgical procedure presents an intriguing suggested alternative to total colectomy in severe, complicated cases.
SUMMARY: Elucidating CDI risk factors, identifying rapid, accurate diagnostic tools, and validating new treatment approaches remains an urgent priority.
Susan M Pacheco; Stuart Johnson
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current opinion in gastroenterology     Volume:  29     ISSN:  1531-7056     ISO Abbreviation:  Curr. Opin. Gastroenterol.     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2012-12-04     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8506887     Medline TA:  Curr Opin Gastroenterol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  42-8     Citation Subset:  IM    
aDepartment of Medicine, Hines VA Hospital, Hines bDepartment of Medicine, Loyola University Medical Center, Maywood cDepartment of Research, Hines VA Hospital, Hines, Illinois, USA.
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