Materiały źródłowe

• #1 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  Clostridioides difficile, formerly known as Clostridium difficile, is a gram-positive and spore-forming bacterium. This obligate anaerobic bacillus is recognized for its ability to produce toxins and cause diarrhea, which is often associated with antibiotic usage. […] The emergence of the newer, hypervirulent, antibiotic-resistant, epidemic strain ribotype 027, also known as the North American pulsed-field gel electrophoresis type 1 (or NAP1) strain has resulted in increased frequency and severity of infections over the last 2 decades. […] The most significant risk factor for C difficile infection is broad-spectrum antibiotics. […] Patients can be colonized with C difficile without symptoms, but antibiotic use disturbs the balance of gut flora, enabling C difficile overgrowth and infection.

• #2 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Clostridioides difficile (formerly Clostridium difficile) is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization by C difficile, and the release of toxins that cause mucosal inflammation and damage. […] The primary risk factor for C difficile colitis is previous exposure to antibiotics; the most commonly implicated agents include the cephalosporins (especially second and third generation), the fluoroquinolones, ampicillin/amoxicillin, and clindamycin. […] Hospitalized patients who occupy a bed whose previous occupant received antibiotics appear to have an increased risk of CDI. […] A US Food and Drug Administration (FDA) safety communication on February 8, 2012, described a possible association between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile associated diarrhea (CDAD).

• #3 Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by SHEA/IDSA

  https://www.idsociety.org/practice-guideline/clostridium-difficile/

  A panel of experts was convened by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) to update the 2010 clinical practice guideline on Clostridium difficile infection (CDI) in adults. […] Clostridium difficile remains the most important cause of healthcare-associated diarrhea and has become the most commonly identified cause of healthcare-associated infection in adults in the United States. […] Moreover, C. difficile has established itself as an important community pathogen. […] Although the prevalence of the epidemic and virulent ribotype 027 strain has declined markedly along with overall CDI rates in parts of Europe, it remains one of the most commonly identified strains in the United States where it causes a sizable minority of CDIs, especially healthcare-associated CDIs.

• #4 C. diff Infection: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15548-c-diff-infection

  Clostridioides difficile, or C. diff, is a highly contagious bacterium that causes diarrhea and colitis. It often infects people who’ve recently taken antibiotics. Antibiotics that kill other bacteria in your gut but don’t kill C. diff allow it to quickly grow out of control. […] The most common cause of C. diff infection is taking antibiotics. Using them upsets the balance between helpful and unhelpful bacteria in your gut microbiome, allowing C. diff to dominate and overgrow. […] C. difficile releases toxins that damage the cells in your intestinal lining. This causes inflammation in your intestinal lining and colon (colitis). Whether you have symptoms, and how severe they are, will depend on the extent of the damage from these toxins. When it’s severe, it can be life-threatening. […] C. diff infection (CDI) is a global health concern, although the exact rates of infection worldwide are unknown. In the U.S., 500,000 infections cause 15,000 deaths each year.

• #5 C. diff: An Urgent Public Health Threat

  https://www.nfid.org/c-diff-an-urgent-public-health-threat/

  C. diff causes nearly 500,000 infections annually […] Clostridioides difficile, or C. diff for short, is a germ that causes diarrhea and colitis (inflammation of the colon) in infected people. […] According to a recent report on the overall burden of CDI in the United States, there are an estimated 500,000 C. diff infections annually, 30,000 of which are fatal. […] C. diff was primarily considered a hospital-associated infection, but there has been a shift in thinking about the primary origin of C. diff infections. […] Moreover, community-associated infections are not subject to the same reporting requirements as hospital-associated infections, making it even harder to get an accurate count of infections across the US. […] In addition to contributing to the rising threat of antibiotic resistance, overuse of antibiotics puts individuals 7-10 times more at risk for contracting C. diff.

• #6 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  The emergence of a newer hypervirulent strain, the North American pulsed-field gel electrophoresis type 1 (NAP1), has been attributed to increased incidence and severity of C difficile infections over the last 2 decades. […] The most significant risk factor for C difficile infection is antibiotic use, particularly broad-spectrum antibiotics. Various antibiotic classes, including penicillins, cephalosporins, fluoroquinolones, and clindamycin, have been associated with the development of the disease. […] C difficile produces 2 types of toxins A and B which are virulent factors in its pathogenicity. Most pathogenic strains associated with C difficile infection produce toxins A and B. […] The emergence of the newer, hypervirulent, antibiotic-resistant, epidemic strain ribotype 027, commonly known as NAP1/B1/027 or the North American pulsed-field gel electrophoresis type 1 strain, is characterized by increased production of toxins A and B, as well as the production of a binary toxin CDT, and fluoroquinolone resistance.

• #7 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Pathogenic strains of C difficile produce two distinct toxins. Toxin A is an enterotoxin, and toxin B is a cytotoxin; both are high molecular weight proteins capable of binding to specific receptors on the intestinal mucosal cells. […] The NAP1 hypervirulent strain of C difficile is associated with the most serious sequelae of CDI, causing severe and fulminant colitis that is characterized by leukocytosis, renal failure, and toxic megacolon. […] The worldwide increased incidence of CDI has been attributed to a variety of risk factors, including more elderly patients in the population, treatment resistance to fluoroquinolones, and the emergence of a newly discovered, more virulent strain of C difficile (BI/NAP1/027).

• #8 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  First recognized in 1978 as a cause of Antibiotic-Associated Diarrhea in 1978 […] Clostridium difficile causes Secretory Diarrhea and mucosal injury with colitis. […] Two toxins are typically produced: Enterotoxin A and Cytotoxin B. […] C. difficile is acquired in health care settings in 94% of cases. […] Recent Antibiotic use within last 3 months (especially last 7-10 days) can cause C. difficile Diarrhea. […] All Antibiotics can cause C. difficile Diarrhea (even single dose perioperative Antibiotics). […] Broad-spectrum agents are highest risk. […] Risk increases with combination Antibiotic regimens, frequent dosing and longer therapy duration. […] Up to 40% of C. difficile are in patients without recent Antibiotic use. […] Most common Antibiotic causes include Clindamycin, Fluoroquinolones, Broad-spectrum Cephalosporins, Ampicillin or Amoxicillin, Macrolides, and Carbapenems.

• #9 Clostridium Difficile – Zero To Finals

  https://zerotofinals.com/medicine/infectiousdisease/cdiff/

  The antigen test shows whether C. difficile is present but not whether it is producing toxins. […] Management is with supportive care and oral antibiotics. […] Faecal microbiota transplantation is an option for recurrent cases. […] Pseudomembranous colitis is characterised by inflammation in the large intestine, with yellow/white plaques that form pseudomembranes on the inner surface of the bowel wall. […] Toxic megacolon is a complication of severe inflammation in the large intestine and involves dilation of the colon.

• #10 Clostridioides (formerly Clostridium) difficile–Induced Colitis – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/bacterial-infections-anaerobic-bacteria/clostridioides-formerly-clostridium-difficile-induced-colitis

  When C. difficile bacteria overgrow, they release toxins that cause diarrhea, colitis, and the formation of abnormal membranes (pseudomembranes) in the large intestine. […] Almost any antibiotic can cause this disorder, but clindamycin, penicillins (such as ampicillin and amoxicillin), cephalosporins (such as ceftriaxone), and fluoroquinolones (such as levofloxacin and ciprofloxacin) are implicated most often. […] C. difficile infection is most common when an antibiotic is taken by mouth, but it also occurs when antibiotics are injected into a muscle or given by vein (intravenously). […] Colitis caused by C. difficile infection rarely occurs unless people have recently used antibiotics. However, physically stressful events, such as surgery (typically involving the stomach or intestine), can likely lead to the same kind of imbalance among the type and quantity of bacteria in the intestine or can interfere with the intestine’s intrinsic defense mechanisms, which, in turn, allows C. difficile infection and colitis to develop.

• #11 About C. diff | C. diff | CDC

  https://www.cdc.gov/c-diff/about/index.html

  C. diff is a germ that causes diarrhea and colitis (an inflammation of the colon) and can be life-threatening. […] Most cases of C. diff infection occur when you’ve been taking antibiotics or not long after you’ve finished the antibiotic course. […] C. diff germs spread from person to person in poop, but the bacteria are often found in the environment. […] When C. diff germs are outside the body, they become spores. These spores are an inactive form of the germ and have a protective coating allowing them to live for months or years on surfaces and in the soil. […] Taking antibiotics can affect your microbiome, making you more susceptible to illnesses like C. diff infection. […] A healthy microbiome helps protect you from infection (like C. diff), but antibiotics disrupt your microbiome. […] C. diff infections are an urgent problem in hospitals, nursing homes, and in communities.

• #12 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Advanced age (65 y) and hospitalization (particularly sharing a hospital room with an infected patient, intensive care unit stays, and prolonged hospital stays) are known risk factors for infection with C difficile, as are comorbidities such as kidney disease, liver disease, and cardiovascular disease. […] Risk factors for recurrence of CDI include age older than 65 years, immune compromise, severe underlying illnesses, ongoing antibiotic treatments during CDI, and severe CDI on presentation. […] C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization with C difficile, and release of toxins that cause mucosal inflammation and damage. […] C difficile forms heat-resistant spores that can persist in the environment for several months to years.

• #13 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  The emergence of a newer hypervirulent strain, the North American pulsed-field gel electrophoresis type 1 (NAP1), has been attributed to increased incidence and severity of C difficile infections over the last 2 decades. […] The most significant risk factor for C difficile infection is antibiotic use, particularly broad-spectrum antibiotics. Various antibiotic classes, including penicillins, cephalosporins, fluoroquinolones, and clindamycin, have been associated with the development of the disease. […] C difficile produces 2 types of toxins A and B which are virulent factors in its pathogenicity. Most pathogenic strains associated with C difficile infection produce toxins A and B. […] The emergence of the newer, hypervirulent, antibiotic-resistant, epidemic strain ribotype 027, commonly known as NAP1/B1/027 or the North American pulsed-field gel electrophoresis type 1 strain, is characterized by increased production of toxins A and B, as well as the production of a binary toxin CDT, and fluoroquinolone resistance.

• #14 Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by SHEA/IDSA

  https://www.idsociety.org/practice-guideline/clostridium-difficile/

  The risk of CDI increases with the length of stay, the most appropriate denominator for HO-CDI rates is the number of patient-days. […] The most important modifiable risk factor for the development of CDI is exposure to antibiotic agents. […] The disruption of the intestinal microbiota by antibiotics is long-lasting, and risk of CDI increases both during therapy and in the 3-month period following cessation of therapy. […] The highest risk of CDI (7- to 10-fold increase) appears to be during and in the first month after antibiotic exposure. […] The clinical association between PPI use and CDI is well established. […] The potential role of asymptomatically colonized patients in transmission has recently been highlighted. […] The hands of healthcare personnel, transiently contaminated with C. difficile spores, and environmental contamination are probably the main means by which the organism is spread within healthcare.

• #15 Clostridium difficile (C. diff ) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/c-diff-infection

  People are seven to 10 times more likely to get C. diff while taking antibiotics and for up to one month after, according to the CDC. For some people, an infection may occur several months after completing a course of antibiotics. […] An estimated two-thirds of C. diff infections originate in hospitals, long-term care facilities, or other health care settings. […] C. diff is treated with the very thing that most often causes itantibiotics. However, if you contract C. diff while on antibiotics, your doctor will likely have you stop the medication you are taking and try a different type. […] Unfortunately, C. diff reinfection is fairly common, occurring in about 20 percent of patients.

• #16 C. diff: An Urgent Public Health Threat

  https://www.nfid.org/c-diff-an-urgent-public-health-threat/

  C. diff causes nearly 500,000 infections annually […] Clostridioides difficile, or C. diff for short, is a germ that causes diarrhea and colitis (inflammation of the colon) in infected people. […] According to a recent report on the overall burden of CDI in the United States, there are an estimated 500,000 C. diff infections annually, 30,000 of which are fatal. […] C. diff was primarily considered a hospital-associated infection, but there has been a shift in thinking about the primary origin of C. diff infections. […] Moreover, community-associated infections are not subject to the same reporting requirements as hospital-associated infections, making it even harder to get an accurate count of infections across the US. […] In addition to contributing to the rising threat of antibiotic resistance, overuse of antibiotics puts individuals 7-10 times more at risk for contracting C. diff.

• #17 About C. diff | C. diff | CDC

  https://www.cdc.gov/c-diff/about/index.html

  C. diff is a germ that causes diarrhea and colitis (an inflammation of the colon) and can be life-threatening. […] Most cases of C. diff infection occur when you’ve been taking antibiotics or not long after you’ve finished the antibiotic course. […] C. diff germs spread from person to person in poop, but the bacteria are often found in the environment. […] When C. diff germs are outside the body, they become spores. These spores are an inactive form of the germ and have a protective coating allowing them to live for months or years on surfaces and in the soil. […] Taking antibiotics can affect your microbiome, making you more susceptible to illnesses like C. diff infection. […] A healthy microbiome helps protect you from infection (like C. diff), but antibiotics disrupt your microbiome. […] C. diff infections are an urgent problem in hospitals, nursing homes, and in communities.

• #18 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Clostridioides difficile (formerly Clostridium difficile) is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization by C difficile, and the release of toxins that cause mucosal inflammation and damage. […] The primary risk factor for C difficile colitis is previous exposure to antibiotics; the most commonly implicated agents include the cephalosporins (especially second and third generation), the fluoroquinolones, ampicillin/amoxicillin, and clindamycin. […] Hospitalized patients who occupy a bed whose previous occupant received antibiotics appear to have an increased risk of CDI. […] A US Food and Drug Administration (FDA) safety communication on February 8, 2012, described a possible association between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile associated diarrhea (CDAD).

• #19 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  First recognized in 1978 as a cause of Antibiotic-Associated Diarrhea in 1978 […] Clostridium difficile causes Secretory Diarrhea and mucosal injury with colitis. […] Two toxins are typically produced: Enterotoxin A and Cytotoxin B. […] C. difficile is acquired in health care settings in 94% of cases. […] Recent Antibiotic use within last 3 months (especially last 7-10 days) can cause C. difficile Diarrhea. […] All Antibiotics can cause C. difficile Diarrhea (even single dose perioperative Antibiotics). […] Broad-spectrum agents are highest risk. […] Risk increases with combination Antibiotic regimens, frequent dosing and longer therapy duration. […] Up to 40% of C. difficile are in patients without recent Antibiotic use. […] Most common Antibiotic causes include Clindamycin, Fluoroquinolones, Broad-spectrum Cephalosporins, Ampicillin or Amoxicillin, Macrolides, and Carbapenems.

• #20 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Clostridioides difficile (formerly Clostridium difficile) is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization by C difficile, and the release of toxins that cause mucosal inflammation and damage. […] The primary risk factor for C difficile colitis is previous exposure to antibiotics; the most commonly implicated agents include the cephalosporins (especially second and third generation), the fluoroquinolones, ampicillin/amoxicillin, and clindamycin. […] Hospitalized patients who occupy a bed whose previous occupant received antibiotics appear to have an increased risk of CDI. […] A US Food and Drug Administration (FDA) safety communication on February 8, 2012, described a possible association between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile associated diarrhea (CDAD).

• #21 C. Diff Infection: Symptoms, Causes, Diagnosis and Treatment

  https://www.webmd.com/digestive-disorders/clostridioides-difficile-colitis

  Clostridium difficile (C. diff) is a highly contagious bacterial infection of the colon. It’s typically caused by taking certain antibiotics, which can interfere with the balance between good and bad bacteria in your gut. […] A new strain of C. diff bacteria makes larger amounts of toxins. These types are hard to treat with medications. […] Clostridioides difficile exists all around us. It’s in the air, water, soil, and the feces of humans and animals. […] You can also become infected if you touch clothing, sheets, or other surfaces that have come in contact with feces and then touch your mouth or nose. […] Older adults in health care facilities are most at risk, especially if they’re taking antibiotics. […] The antibiotics that are most linked to a risk of C. diff infection are: Cephalosporins, Clindamycin, Fluoroquinolones, Penicillins.

• #22 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  Clindamycin has an Odds Ratio of 16 for causing C. difficile. […] Fluoroquinolones have an Odds Ratio of 5.5. […] Broad-spectrum Cephalosporins have an Odds Ratio of 5.7. […] Ampicillin or Amoxicillin is the most common cause in the United States with an Odds Ratio of 2.7. […] Metronidazole is no longer recommended by IDSA as first line protocol for mild to moderate Clostridium difficile. […] Metronidazole has historically been preferred for mild to moderate infection.

• #23 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  Clindamycin has an Odds Ratio of 16 for causing C. difficile. […] Fluoroquinolones have an Odds Ratio of 5.5. […] Broad-spectrum Cephalosporins have an Odds Ratio of 5.7. […] Ampicillin or Amoxicillin is the most common cause in the United States with an Odds Ratio of 2.7. […] Metronidazole is no longer recommended by IDSA as first line protocol for mild to moderate Clostridium difficile. […] Metronidazole has historically been preferred for mild to moderate infection.

• #24 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  First recognized in 1978 as a cause of Antibiotic-Associated Diarrhea in 1978 […] Clostridium difficile causes Secretory Diarrhea and mucosal injury with colitis. […] Two toxins are typically produced: Enterotoxin A and Cytotoxin B. […] C. difficile is acquired in health care settings in 94% of cases. […] Recent Antibiotic use within last 3 months (especially last 7-10 days) can cause C. difficile Diarrhea. […] All Antibiotics can cause C. difficile Diarrhea (even single dose perioperative Antibiotics). […] Broad-spectrum agents are highest risk. […] Risk increases with combination Antibiotic regimens, frequent dosing and longer therapy duration. […] Up to 40% of C. difficile are in patients without recent Antibiotic use. […] Most common Antibiotic causes include Clindamycin, Fluoroquinolones, Broad-spectrum Cephalosporins, Ampicillin or Amoxicillin, Macrolides, and Carbapenems.

• #25 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  First recognized in 1978 as a cause of Antibiotic-Associated Diarrhea in 1978 […] Clostridium difficile causes Secretory Diarrhea and mucosal injury with colitis. […] Two toxins are typically produced: Enterotoxin A and Cytotoxin B. […] C. difficile is acquired in health care settings in 94% of cases. […] Recent Antibiotic use within last 3 months (especially last 7-10 days) can cause C. difficile Diarrhea. […] All Antibiotics can cause C. difficile Diarrhea (even single dose perioperative Antibiotics). […] Broad-spectrum agents are highest risk. […] Risk increases with combination Antibiotic regimens, frequent dosing and longer therapy duration. […] Up to 40% of C. difficile are in patients without recent Antibiotic use. […] Most common Antibiotic causes include Clindamycin, Fluoroquinolones, Broad-spectrum Cephalosporins, Ampicillin or Amoxicillin, Macrolides, and Carbapenems.

• #26 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  First recognized in 1978 as a cause of Antibiotic-Associated Diarrhea in 1978 […] Clostridium difficile causes Secretory Diarrhea and mucosal injury with colitis. […] Two toxins are typically produced: Enterotoxin A and Cytotoxin B. […] C. difficile is acquired in health care settings in 94% of cases. […] Recent Antibiotic use within last 3 months (especially last 7-10 days) can cause C. difficile Diarrhea. […] All Antibiotics can cause C. difficile Diarrhea (even single dose perioperative Antibiotics). […] Broad-spectrum agents are highest risk. […] Risk increases with combination Antibiotic regimens, frequent dosing and longer therapy duration. […] Up to 40% of C. difficile are in patients without recent Antibiotic use. […] Most common Antibiotic causes include Clindamycin, Fluoroquinolones, Broad-spectrum Cephalosporins, Ampicillin or Amoxicillin, Macrolides, and Carbapenems.

• #27 Common Questions About Clostridium difficile Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0315/p437.html

  Risk factors for the development of C. difficile infection include age older than 64 years, recent hospitalization, antibiotic use, multiple comorbidities, use of gastric acid blockers, previous gastrointestinal surgery, inflammatory bowel disease, and immunosuppression. […] Antibiotic exposure is the most important modifiable risk factor. […] Although even single doses of prophylactic antibiotics can cause C. difficile infection, greater number of antimicrobials used, greater number of doses, and longer duration of antibiotic administration increase the risk. […] Treatment includes discontinuing the contributing antibiotic, if it is no longer indicated or an alternative is available. […] The Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America recommend oral metronidazole for mild cases of C. difficile infection. Oral vancomycin is the preferred agent for severe infection.

• #28 Clostridium difficile

  https://mobile.fpnotebook.com/GI/ID/ClstrdmDfcl.htm

  First recognized in 1978 as a cause of Antibiotic-Associated Diarrhea in 1978 […] Clostridium difficile causes Secretory Diarrhea and mucosal injury with colitis. […] Two toxins are typically produced: Enterotoxin A and Cytotoxin B. […] C. difficile is acquired in health care settings in 94% of cases. […] Recent Antibiotic use within last 3 months (especially last 7-10 days) can cause C. difficile Diarrhea. […] All Antibiotics can cause C. difficile Diarrhea (even single dose perioperative Antibiotics). […] Broad-spectrum agents are highest risk. […] Risk increases with combination Antibiotic regimens, frequent dosing and longer therapy duration. […] Up to 40% of C. difficile are in patients without recent Antibiotic use. […] Most common Antibiotic causes include Clindamycin, Fluoroquinolones, Broad-spectrum Cephalosporins, Ampicillin or Amoxicillin, Macrolides, and Carbapenems.

• #29 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Advanced age (65 y) and hospitalization (particularly sharing a hospital room with an infected patient, intensive care unit stays, and prolonged hospital stays) are known risk factors for infection with C difficile, as are comorbidities such as kidney disease, liver disease, and cardiovascular disease. […] Risk factors for recurrence of CDI include age older than 65 years, immune compromise, severe underlying illnesses, ongoing antibiotic treatments during CDI, and severe CDI on presentation. […] C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization with C difficile, and release of toxins that cause mucosal inflammation and damage. […] C difficile forms heat-resistant spores that can persist in the environment for several months to years.

• #30 Clostridium Difficile (C. Diff): Symptoms and Treatment

  https://patient.info/digestive-health/clostridium-difficile-c-diff

  Infection with Clostridioides difficile (sometimes just called 'C. diff’) most commonly occurs in people who have recently had a course of antibiotics and are in hospital. […] The most common reason this occurs is after taking antibiotics. […] If you take antibiotics for any infection (eg, urine infection or skin infection), as well as killing the bacteria that cause the infection, the antibiotics will also kill many of the harmless bacteria that live in your gut. C. difficile bacteria are not killed by many types of antibiotic. […] Therefore, if you take certain antibiotics and if you have any C. difficile bacteria in your gut, the bacteria may thrive and cause an infection. This is a problem that may occur with taking many of the commonly used antibiotics. […] C. difficile infection is more common in older people. Over 8 in 10 cases occur in people over the age of 65. This is partly because older people are more commonly in hospital. Also, older people seem to be more prone to this infection.

• #31 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Advanced age (65 y) and hospitalization (particularly sharing a hospital room with an infected patient, intensive care unit stays, and prolonged hospital stays) are known risk factors for infection with C difficile, as are comorbidities such as kidney disease, liver disease, and cardiovascular disease. […] Risk factors for recurrence of CDI include age older than 65 years, immune compromise, severe underlying illnesses, ongoing antibiotic treatments during CDI, and severe CDI on presentation. […] C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization with C difficile, and release of toxins that cause mucosal inflammation and damage. […] C difficile forms heat-resistant spores that can persist in the environment for several months to years.

• #32 Clostridioides difficile (C. difficile) | Wisconsin Department of Health Services

  https://www.dhs.wisconsin.gov/disease/clostridioides-difficile.htm

  Clostridioides difficile, often called C. difficile or C. diff, is a type of bacteria that causes diarrhea and inflammation of the colon also called colitis. C. difficile can affect anyone, but those taking antibiotics are most at risk for infection. […] Most C. difficile infections occur while taking antibiotics or shortly after taking antibiotics. This is because antibiotics can disrupt our microbiome, which is the balance of good and bad bacteria that live in and on our bodies. […] C. difficile can be spread through direct contact with someone who has a C. difficile infection or by someone who carries the bacteria but shows no signs or symptoms of infection (called colonization). […] People at higher risk for developing C. difficile infection include people who: Have recently taken antibiotics for more than a week. Are over the age of 65. Had a recent or prolonged stay in a hospital or long-term care facility. Have a weakened immune system (such as people with cancer or HIV/AIDS). Had a previous C. difficile infection or an exposure to the germs. […] Some people who are treated for C. difficile infection may become infected again in the next two to eight weeks.

• #33 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Clostridioides difficile (formerly Clostridium difficile) is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization by C difficile, and the release of toxins that cause mucosal inflammation and damage. […] The primary risk factor for C difficile colitis is previous exposure to antibiotics; the most commonly implicated agents include the cephalosporins (especially second and third generation), the fluoroquinolones, ampicillin/amoxicillin, and clindamycin. […] Hospitalized patients who occupy a bed whose previous occupant received antibiotics appear to have an increased risk of CDI. […] A US Food and Drug Administration (FDA) safety communication on February 8, 2012, described a possible association between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile associated diarrhea (CDAD).

• #34 Fact Sheet – Clostridium difficile (C. difficile) – Canada.ca

  https://www.canada.ca/en/public-health/services/infectious-diseases/fact-sheet-clostridium-difficile-difficile.html

  Those at higher risk include the elderly, people with severe underlying illness, and people taking certain antibiotics (especially over a prolonged period of time) or cancer chemotherapy. […] In addition, patients taking stomach ulcer drugs, known as proton pump inhibitors, are at increased risk for contracting C. difficile infection.

• #35 C. diff Infection | Infectious Diseases

  https://health.ucdavis.edu/conditions/c-diff-infection

  If you had a C. diff infection in the last eight weeks, you’re more likely to get a repeat infection. […] C. diff infections are more common in health care settings like hospitals, extended-care facilities and nursing homes. […] Having surgery on your intestines increases the risk of getting a C. diff infection. […] People who take immune-suppressing drugs or have an immune system condition like HIV are more likely to get C. diff.

• #36 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Advanced age (65 y) and hospitalization (particularly sharing a hospital room with an infected patient, intensive care unit stays, and prolonged hospital stays) are known risk factors for infection with C difficile, as are comorbidities such as kidney disease, liver disease, and cardiovascular disease. […] Risk factors for recurrence of CDI include age older than 65 years, immune compromise, severe underlying illnesses, ongoing antibiotic treatments during CDI, and severe CDI on presentation. […] C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization with C difficile, and release of toxins that cause mucosal inflammation and damage. […] C difficile forms heat-resistant spores that can persist in the environment for several months to years.

• #37 What Is C. Diff? Symptoms, Causes, Diagnosis, Treatment, and Prevention

  https://www.everydayhealth.com/c-diff/guide/

  Although people with no known risk factors can get a C. diff infection, certain things increase your risk, including the heavy use of antibiotics for the treatment of long-term infections. These antibiotics can disrupt the normal makeup of the gut microbiome the community of microbes living in the intestines allowing C. diff to grow out of control and cause an infection. […] Risk factors also include older age, having a severe underlying disease such as inflammatory bowel disease (IBD) or colorectal cancer, or having a weakened immune system. […] Your risk of C. diff infection is greater if youve had abdominal surgery or a gastrointestinal surgical procedure. […] Furthermore, having a C. diff infection once increases your chance of having it again. […] Most C. diff infections occur in people who are or who have recently been in healthcare facilities such as hospitals, nursing homes, and rehabilitation centers. In these facilities, germs spread easily, antibiotic use is common, and patients are particularly vulnerable to infection.

• #38 Common Questions About Clostridium difficile Infection | AAFP

  https://www.aafp.org/pubs/afp/issues/2014/0315/p437.html

  Risk factors for the development of C. difficile infection include age older than 64 years, recent hospitalization, antibiotic use, multiple comorbidities, use of gastric acid blockers, previous gastrointestinal surgery, inflammatory bowel disease, and immunosuppression. […] Antibiotic exposure is the most important modifiable risk factor. […] Although even single doses of prophylactic antibiotics can cause C. difficile infection, greater number of antimicrobials used, greater number of doses, and longer duration of antibiotic administration increase the risk. […] Treatment includes discontinuing the contributing antibiotic, if it is no longer indicated or an alternative is available. […] The Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America recommend oral metronidazole for mild cases of C. difficile infection. Oral vancomycin is the preferred agent for severe infection.

• #39 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Advanced age (65 y) and hospitalization (particularly sharing a hospital room with an infected patient, intensive care unit stays, and prolonged hospital stays) are known risk factors for infection with C difficile, as are comorbidities such as kidney disease, liver disease, and cardiovascular disease. […] Risk factors for recurrence of CDI include age older than 65 years, immune compromise, severe underlying illnesses, ongoing antibiotic treatments during CDI, and severe CDI on presentation. […] C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization with C difficile, and release of toxins that cause mucosal inflammation and damage. […] C difficile forms heat-resistant spores that can persist in the environment for several months to years.

• #40 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  Clostridioides difficile, formerly known as Clostridium difficile, is a gram-positive and spore-forming bacterium. This obligate anaerobic bacillus is recognized for its ability to produce toxins and cause diarrhea, which is often associated with antibiotic usage. […] The emergence of the newer, hypervirulent, antibiotic-resistant, epidemic strain ribotype 027, also known as the North American pulsed-field gel electrophoresis type 1 (or NAP1) strain has resulted in increased frequency and severity of infections over the last 2 decades. […] The most significant risk factor for C difficile infection is broad-spectrum antibiotics. […] Patients can be colonized with C difficile without symptoms, but antibiotic use disturbs the balance of gut flora, enabling C difficile overgrowth and infection.

• #41 Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by SHEA/IDSA

  https://www.idsociety.org/practice-guideline/clostridium-difficile/

  CDI is defined by the presence of symptoms (usually diarrhea) and either a stool test positive for C. difficile toxins or detection of toxigenic C. difficile, or colonoscopic or histopathologic findings revealing pseudomembranous colitis. […] The extent to which these guidelines can be implemented is impacted by the size of the institution and the resources, both financial and laboratory, available in the particular clinical setting. […] C. difficile is the most commonly recognized cause of infectious diarrhea in healthcare settings. […] The emergence of the virulent, epidemic ribotype 027 strain was associated with increased incidence, severity, and mortality during the mid-2000s and resulted in outbreaks across North America. […] The recent isolates of the 027 strain are more highly resistant to fluoroquinolones compared to historic strains of the same type.

• #42 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  The emergence of a newer hypervirulent strain, the North American pulsed-field gel electrophoresis type 1 (NAP1), has been attributed to increased incidence and severity of C difficile infections over the last 2 decades. […] The most significant risk factor for C difficile infection is antibiotic use, particularly broad-spectrum antibiotics. Various antibiotic classes, including penicillins, cephalosporins, fluoroquinolones, and clindamycin, have been associated with the development of the disease. […] C difficile produces 2 types of toxins A and B which are virulent factors in its pathogenicity. Most pathogenic strains associated with C difficile infection produce toxins A and B. […] The emergence of the newer, hypervirulent, antibiotic-resistant, epidemic strain ribotype 027, commonly known as NAP1/B1/027 or the North American pulsed-field gel electrophoresis type 1 strain, is characterized by increased production of toxins A and B, as well as the production of a binary toxin CDT, and fluoroquinolone resistance.

• #43 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  The emergence of a newer hypervirulent strain, the North American pulsed-field gel electrophoresis type 1 (NAP1), has been attributed to increased incidence and severity of C difficile infections over the last 2 decades. […] The most significant risk factor for C difficile infection is antibiotic use, particularly broad-spectrum antibiotics. Various antibiotic classes, including penicillins, cephalosporins, fluoroquinolones, and clindamycin, have been associated with the development of the disease. […] C difficile produces 2 types of toxins A and B which are virulent factors in its pathogenicity. Most pathogenic strains associated with C difficile infection produce toxins A and B. […] The emergence of the newer, hypervirulent, antibiotic-resistant, epidemic strain ribotype 027, commonly known as NAP1/B1/027 or the North American pulsed-field gel electrophoresis type 1 strain, is characterized by increased production of toxins A and B, as well as the production of a binary toxin CDT, and fluoroquinolone resistance.

• #44 Clostridium difficile and the disease it causes – PubMed

  https://pubmed.ncbi.nlm.nih.gov/20597000/

  Clostridium difficile is a spore-forming, toxin-producing, anaerobic bacterium abundant in soils and water. Frequent and early colonization of the human intestinal flora is common and often asymptomatic. Antimicrobials given commonly disrupt the intestinal microflora and through proliferation in colon and production of toxin A and B it precipitates C. difficile infection (CDI). […] Infection is acquired from an endogenous source or from spores in the environment, most easily facilitated during hospital stay. […] The current epidemic of the C. difficile strain NAP1/027 emerging in 2002 in Canada and the USA has now spread to most parts of Europe and virulence factors like high toxin production and sporulation challenge the therapeutic situation and cause great concern among infection control workers. […] Excessive use of modern fluoroquinolones is thought to play an important role in facilitating this epidemic since NAP1/027 was shown to have acquired moxifloxacin resistance compared to historical strains of the same genotype.

• #45 Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by SHEA/IDSA

  https://www.idsociety.org/practice-guideline/clostridium-difficile/

  CDI is defined by the presence of symptoms (usually diarrhea) and either a stool test positive for C. difficile toxins or detection of toxigenic C. difficile, or colonoscopic or histopathologic findings revealing pseudomembranous colitis. […] The extent to which these guidelines can be implemented is impacted by the size of the institution and the resources, both financial and laboratory, available in the particular clinical setting. […] C. difficile is the most commonly recognized cause of infectious diarrhea in healthcare settings. […] The emergence of the virulent, epidemic ribotype 027 strain was associated with increased incidence, severity, and mortality during the mid-2000s and resulted in outbreaks across North America. […] The recent isolates of the 027 strain are more highly resistant to fluoroquinolones compared to historic strains of the same type.

• #46 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  The emergence of a newer hypervirulent strain, the North American pulsed-field gel electrophoresis type 1 (NAP1), has been attributed to increased incidence and severity of C difficile infections over the last 2 decades. […] The most significant risk factor for C difficile infection is antibiotic use, particularly broad-spectrum antibiotics. Various antibiotic classes, including penicillins, cephalosporins, fluoroquinolones, and clindamycin, have been associated with the development of the disease. […] C difficile produces 2 types of toxins A and B which are virulent factors in its pathogenicity. Most pathogenic strains associated with C difficile infection produce toxins A and B. […] The emergence of the newer, hypervirulent, antibiotic-resistant, epidemic strain ribotype 027, commonly known as NAP1/B1/027 or the North American pulsed-field gel electrophoresis type 1 strain, is characterized by increased production of toxins A and B, as well as the production of a binary toxin CDT, and fluoroquinolone resistance.

• #47 How to Prevent C. Diff Infection from Recurring

  https://www.healthline.com/health/preventing-c-diff-infection-from-recurring

  Studies have found that previous use of antibiotics increases the risk of recurrent C. diff infection. […] Since 2003, C. diff cases have become more frequent, harmful, recurring, and less responsive to treatment. This may be due to the emergence of a severe strain of C. diff known as NAP1/BI/027. […] This specific strain of C. diff produces more toxins than other strains. […] Risk factors such as older age, antibiotic use, gastric acid suppression, and a weakened immune system may increase the likelihood of C. diff recurrence.

• #48 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Pathogenic strains of C difficile produce two distinct toxins. Toxin A is an enterotoxin, and toxin B is a cytotoxin; both are high molecular weight proteins capable of binding to specific receptors on the intestinal mucosal cells. […] The NAP1 hypervirulent strain of C difficile is associated with the most serious sequelae of CDI, causing severe and fulminant colitis that is characterized by leukocytosis, renal failure, and toxic megacolon. […] The worldwide increased incidence of CDI has been attributed to a variety of risk factors, including more elderly patients in the population, treatment resistance to fluoroquinolones, and the emergence of a newly discovered, more virulent strain of C difficile (BI/NAP1/027).

• #49 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Pathogenic strains of C difficile produce two distinct toxins. Toxin A is an enterotoxin, and toxin B is a cytotoxin; both are high molecular weight proteins capable of binding to specific receptors on the intestinal mucosal cells. […] The NAP1 hypervirulent strain of C difficile is associated with the most serious sequelae of CDI, causing severe and fulminant colitis that is characterized by leukocytosis, renal failure, and toxic megacolon. […] The worldwide increased incidence of CDI has been attributed to a variety of risk factors, including more elderly patients in the population, treatment resistance to fluoroquinolones, and the emergence of a newly discovered, more virulent strain of C difficile (BI/NAP1/027).

• #50 Clostridioides difficile infection – Wikipedia

  https://en.wikipedia.org/wiki/Clostridioides_difficile_infection

  Clostridioides difficile infection is spread by bacterial spores found within feces. […] Risk factors for infection include antibiotic or proton pump inhibitor use, hospitalization, hypoalbuminemia, other health problems, and older age. […] Pathogenic C. difficile strains produce multiple toxins. […] Antibiotic treatment of CDIs may be difficult, due both to antibiotic resistance and physiological factors of the bacteria (spore formation, protective effects of the pseudomembrane). […] The emergence of a new and highly toxic strain of C. difficile that is resistant to fluoroquinolone antibiotics such as ciprofloxacin and levofloxacin, said to be causing geographically dispersed outbreaks in North America, was reported in 2005. […] C. difficile is transmitted from person to person by the fecal-oral route.

• #51

• #52 Pseudomembranous colitis – Symptoms & causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/pseudomembranous-colitis/symptoms-causes/syc-20351434

  C. difficile spores are resistant to many common disinfectants and can be transmitted from the hands of health care professionals to patients. […] More and more often, C. difficile is being reported in people with no known risk factors, including people with no recent health care contact or use of antibiotics. This is called community-acquired C. difficile. […] An aggressive strain of C. difficile has emerged that produces far more toxins than other strains do. The new strain may be more resistant to certain medicines and has been reported in people who haven’t been in the hospital or taken antibiotics.

• #53 Clostridium difficile (C. diff ) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/c-diff-infection

  Clostridium difficile is a type of bacteria commonly found in the soil, air, and water. It is present in small amounts in the bodies of 1 to 3% of the U.S. population. Under normal circumstances, it doesnt cause any harm. But it is opportunistic, and if given room to grow, it multiplies and crowds out the beneficial bacteria in the gut. This can happen during or after a course of antibiotics, which are meant to kill bacteria that cause infections, but also end up wiping out the helpful bacteria. […] A C. diff infection causes diarrhea, which can range from mild to severe, and in rare cases, can lead to serious complications. The infection most often enters the body after someone touches a surface contaminated with feces from a person infected with C. diff and then touches his or her mouth.

• #54 C. diff (Clostridium difficile): Symptoms and Treatment

  https://www.healthline.com/health/what-is-c-diff

  C. diff is a type of bacteria that can cause diarrhea, abdominal pain, and tenderness. […] C. diff, short for Clostridium difficile, is a form of infectious bacterium. It can cause a range of symptoms but most commonly results in colitis, which is the inflammation of the wall of your colon. […] According to the American College of Gastroenterology, between 4% and 15% of healthy adults have C. diff in their intestines. Up to 70% of infants have C. diff at birth, reports the Centers for Disease Control and Prevention (CDC). […] Other bacteria that live in the intestines usually keep the amount of C. diff under control. However, in some instances, a C. diff infection can occur. This includes via: […] C. diff is contagious and can pass from person to person. […] Taking antibiotics: Antibiotics help fight off bad bacteria. However, the drug doesn’t always know the difference between good and bad germs. This means it may sometimes remove good bacteria that protect our body from infections like C. diff.

• #55 C. diff Infection: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15548-c-diff-infection

  A healthy immune system normally protects your gut from C. diff infection by keeping C. diff levels under control. If they grow out of control, it’s because something has affected the balance between helpful bacteria and unhelpful bacteria. […] Researchers estimate about 5% of the population has C. difficile in their colon without signs or symptoms of infection. You can have C. diff under control, but still carry and spread it to others. […] Sometimes, it isn’t clear what allowed C. diff to take over. While many factors can affect your gut immunity, it’s important to know that infection can occur even if you don’t have any known risk factors.

• #56 Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by SHEA/IDSA

  https://www.idsociety.org/practice-guideline/clostridium-difficile/

  The risk of CDI increases with the length of stay, the most appropriate denominator for HO-CDI rates is the number of patient-days. […] The most important modifiable risk factor for the development of CDI is exposure to antibiotic agents. […] The disruption of the intestinal microbiota by antibiotics is long-lasting, and risk of CDI increases both during therapy and in the 3-month period following cessation of therapy. […] The highest risk of CDI (7- to 10-fold increase) appears to be during and in the first month after antibiotic exposure. […] The clinical association between PPI use and CDI is well established. […] The potential role of asymptomatically colonized patients in transmission has recently been highlighted. […] The hands of healthcare personnel, transiently contaminated with C. difficile spores, and environmental contamination are probably the main means by which the organism is spread within healthcare.

• #57 Clostridioides difficile infection – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK431054/

  C difficile infection has primarily been associated with healthcare settings. However, recent reports indicate a surge in C difficile infections in the community among individuals with no healthcare system affiliation or exposure to antibiotics. […] The healthcare environment presents a conducive setting for C difficile transmission, owing to the challenge of eradicating spores and the prevalent use of antimicrobials, which fosters the development of C difficile infections. […] The most significant risk factor for developing C difficile infection is the use of antibiotics, particularly broad-spectrum antibiotics. […] The link between antibiotics and the onset of C difficile infections stems from the dysbiosis within the gut microbiome ecosystem induced by antibiotic use.

• #58 C. Diff Infection: Symptoms, Causes, Diagnosis and Treatment

  https://www.webmd.com/digestive-disorders/clostridioides-difficile-colitis

  An increasing number of younger people also develop C. diff infections, even without taking antibiotics or being in a hospital. […] If a C. diff infection isn’t treated quickly, you could become dehydrated due to severe diarrhea. […] A C. diff infection also can lead to rare problems such as: Leaking from your colon, Pseudomembranous colitis, Reactive arthritis, Toxic megacolon, Bowel perforation. […] The more severe your C. diff infection is, the higher the likelihood of complications. […] Many C. diff infections are mild and short-lived, but others can be quite serious. […] After having C. diff, it’s important to reintroduce „good” bacteria back into your gut. […] There is limited evidence about the role probiotics play in helping to treat or prevent C. diff.

• #59 Clostridioides difficile – Wikipedia

  https://en.wikipedia.org/wiki/Clostridioides_difficile

  Individuals with no history of gastrointestinal disturbances appear unlikely to become asymptomatic carriers. These carriers are thought to be a major reservoir of infection. […] Pathogenic C. difficile strains produce multiple toxins. […] The best-characterized are enterotoxin (C. difficile toxin A) and cytotoxin (C. difficile toxin B), both of which may produce diarrhea and inflammation in infected patients (C. difficile colitis), although their relative contributions have been debated. […] Antibiotic treatment of C. diff infections may be difficult, due both to antibiotic resistance and physiological factors of the bacterium (spore formation, protective effects of the pseudomembrane). […] The emergence of a new, highly toxic strain of C. difficile, resistant to fluoroquinolone antibiotics, such as ciprofloxacin and levofloxacin, said to be causing geographically dispersed outbreaks in North America, was reported in 2005.

• #60 C. diff Infection: What It Is, Symptoms & Treatment

  https://my.clevelandclinic.org/health/diseases/15548-c-diff-infection

  Clostridioides difficile, or C. diff, is a highly contagious bacterium that causes diarrhea and colitis. It often infects people who’ve recently taken antibiotics. Antibiotics that kill other bacteria in your gut but don’t kill C. diff allow it to quickly grow out of control. […] The most common cause of C. diff infection is taking antibiotics. Using them upsets the balance between helpful and unhelpful bacteria in your gut microbiome, allowing C. diff to dominate and overgrow. […] C. difficile releases toxins that damage the cells in your intestinal lining. This causes inflammation in your intestinal lining and colon (colitis). Whether you have symptoms, and how severe they are, will depend on the extent of the damage from these toxins. When it’s severe, it can be life-threatening. […] C. diff infection (CDI) is a global health concern, although the exact rates of infection worldwide are unknown. In the U.S., 500,000 infections cause 15,000 deaths each year.

• #61 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Clostridioides difficile (formerly Clostridium difficile) is a gram-positive, anaerobic, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and colitis. C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization by C difficile, and the release of toxins that cause mucosal inflammation and damage. […] The primary risk factor for C difficile colitis is previous exposure to antibiotics; the most commonly implicated agents include the cephalosporins (especially second and third generation), the fluoroquinolones, ampicillin/amoxicillin, and clindamycin. […] Hospitalized patients who occupy a bed whose previous occupant received antibiotics appear to have an increased risk of CDI. […] A US Food and Drug Administration (FDA) safety communication on February 8, 2012, described a possible association between the use of proton pump inhibitors (PPIs) and the development of Clostridium difficile associated diarrhea (CDAD).

• #62 About C. diff | C. diff | CDC

  https://www.cdc.gov/c-diff/about/index.html

  C. diff is a germ that causes diarrhea and colitis (an inflammation of the colon) and can be life-threatening. […] Most cases of C. diff infection occur when you’ve been taking antibiotics or not long after you’ve finished the antibiotic course. […] C. diff germs spread from person to person in poop, but the bacteria are often found in the environment. […] When C. diff germs are outside the body, they become spores. These spores are an inactive form of the germ and have a protective coating allowing them to live for months or years on surfaces and in the soil. […] Taking antibiotics can affect your microbiome, making you more susceptible to illnesses like C. diff infection. […] A healthy microbiome helps protect you from infection (like C. diff), but antibiotics disrupt your microbiome. […] C. diff infections are an urgent problem in hospitals, nursing homes, and in communities.

• #63 Clostridioides (formerly Clostridium) difficile–Induced Colitis – Infections – Merck Manual Consumer Version

  https://www.merckmanuals.com/home/infections/bacterial-infections-anaerobic-bacteria/clostridioides-formerly-clostridium-difficile-induced-colitis

  Clostridioides difficile (C. difficile) induced colitis is an inflammation of the large intestine (colon) that results in diarrhea. The inflammation is caused by toxin produced by C. difficile bacteria and usually develops after people take antibiotics that enable these bacteria to grow in the intestine. […] In C. difficile induced colitis, the bacteria produce toxins that cause inflammation of the colon (colitis), usually after antibiotics are taken to treat an infection. Many antibiotics alter the balance among the types and quantity of bacteria that live in the intestine. Thus, certain disease-causing bacteria, such as C. difficile, can overgrow and replace the harmless bacteria that normally live in the intestine. C. difficile is the most common cause of colitis that develops after antibiotics are taken.

• #64 C. difficile infection – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691

  Clostridioides difficile (klos-TRID-e-oi-deez dif-uh-SEEL) is a bacterium that causes an infection of the colon, the longest part of the large intestine. […] Illness from C. difficile often occurs after using antibiotic medicines. […] C. difficile bacteria enter the body through the mouth. They can begin reproducing in the small intestine. When they reach the part of the large intestine, called the colon, the bacteria can release toxins that damage tissues. These toxins destroy cells and cause watery diarrhea. […] Some people carry C. difficile bacteria in their intestines but never get sick from it. These people are carriers of the bacteria. They can spread infections without being sick. […] The intestines house a wide range of bacteria. Many of them help protect the body from infection. Antibiotics that treat an infection tend to destroy some of the helpful bacteria in the body as well as the bacteria causing the infection.

• #65 C. diff infections and rethinking prevention

  https://www.astrazeneca.com/what-science-can-do/topics/disease-understanding/rethinking-prevention-of-recurrent-c-diff-infections.html

  Clostridioides difficile, or C. diff, is a bacterium that can cause severe diarrhea and intestinal inflammation that may be life-threatening. […] C. diff is one of the leading causes of healthcare-associated infections in the U.S., with approximately 500,000 infections diagnosed each year. […] People are most at-risk for contracting a C. diff infection (CDI) when they are prescribed antibiotics for another infection. […] When C. diff spores, an inactive and protected form of the bacteria found in the environment or stool, are ingested, they germinate, or become active, in the intestines. […] However, in those with a disrupted gut microbiome, such as a person who has recently taken antibiotics, C. diff spores may colonize the intestinal tract, leading to growth and proliferation of the bacteria and, ultimately, the production of symptom causing toxins.

• #66 Clostridium difficile: Causes, symptoms, and treatment

  https://www.medicalnewstoday.com/articles/172329

  However, healthcare environments such as hospitals, nursing homes, and long-term healthcare facilities most often host C. difficile. A significant proportion of people staying or living in these settings carry high levels of the bacterium. […] If a person takes antibiotics to treat a different infection, they may destroy some of the helpful bacteria, allowing C. difficile to reproduce more rapidly and dominate the gut. […] Types of antibiotic that may contribute to C. difficile infection include fluoroquinolones, cephalosporins, clindamycin, and penicillin. However, any antibiotic can increase the risk of C. difficile if it decreases the amount of protective bacteria in the gut. […] Once C. difficile reaches the stage of infection, it produces toxins that destroy cells and cause inflammation inside the colon. […] When C. difficile occurs naturally in the gut, people cannot normally pass the infection on to others unless the bacteria start producing toxins.

• #67 C. difficile infection – Symptoms and causes – Mayo Clinic

  https://www.mayoclinic.org/diseases-conditions/c-difficile/symptoms-causes/syc-20351691

  Clostridioides difficile (klos-TRID-e-oi-deez dif-uh-SEEL) is a bacterium that causes an infection of the colon, the longest part of the large intestine. […] Illness from C. difficile often occurs after using antibiotic medicines. […] C. difficile bacteria enter the body through the mouth. They can begin reproducing in the small intestine. When they reach the part of the large intestine, called the colon, the bacteria can release toxins that damage tissues. These toxins destroy cells and cause watery diarrhea. […] Some people carry C. difficile bacteria in their intestines but never get sick from it. These people are carriers of the bacteria. They can spread infections without being sick. […] The intestines house a wide range of bacteria. Many of them help protect the body from infection. Antibiotics that treat an infection tend to destroy some of the helpful bacteria in the body as well as the bacteria causing the infection.

• #68 Clostridioides Difficile Infection (CDI) – IFFGD

  https://iffgd.org/gi-disorders/other-disorders/clostridium-difficile/

  Clostridioides difficile infection or C. difficile is a bacterium that can infect the large bowel (or colon) and is a major cause of infectious colitis and diarrhea in healthcare settings around the world. […] The C. difficile infection occurs when the C. difficile bacteria multiply and are able to grow within the gastrointestinal (GI) system. […] The changes that result from antibiotics can allow C. difficile to multiply and release toxins causing colitis by damaging the lining of the colon. […] But the mere exposure to C. Difficile doesnt necessarily mean that one will develop C.difficile colitis. […] The main risk factor for CDI is exposure to the bacteria and use of antibiotics. […] Long-term antibiotic treatments or taking multiple antibiotics at the same time can further increase the risk for CDI.

• #69 C diff (Clostridium difficile) Infection – familydoctor.org

  https://familydoctor.org/condition/clostridium-difficile-c-diff-infection/

  Clostridium difficile (C. diff.) is a type of bacteria that lives in many people’s intestines. C. diff. is part of the normal balance of bacteria in your body. It also lives in the environment, such as in soil, water, and animal feces. […] Most people never have problems with C. diff. However, if there is an imbalance in your intestines, C. diff. may begin to grow out of control. The bacteria start to release toxins that irritate and attack the lining of your intestines. This is what leads to symptoms of a C. diff. infection. […] The most common risk factor for C. diff. is the use of an antibiotics. Antibiotics can disrupt the normal balance in your intestines. Your risk increases if you have taken antibiotics for a long period of time or if the antibiotic is broad-spectrum (treats a wide variety of bacteria).

• #70 Clostridium difficile (C. diff ) > Fact Sheets > Yale Medicine

  https://www.yalemedicine.org/conditions/c-diff-infection

  People are seven to 10 times more likely to get C. diff while taking antibiotics and for up to one month after, according to the CDC. For some people, an infection may occur several months after completing a course of antibiotics. […] An estimated two-thirds of C. diff infections originate in hospitals, long-term care facilities, or other health care settings. […] C. diff is treated with the very thing that most often causes itantibiotics. However, if you contract C. diff while on antibiotics, your doctor will likely have you stop the medication you are taking and try a different type. […] Unfortunately, C. diff reinfection is fairly common, occurring in about 20 percent of patients.

• #71 C. Difficile (C. diff) | Sepsis Alliance

  https://www.sepsis.org/sepsisand/c-difficile/

  People who are in hospitals or other healthcare settings are at highest risk of developing C. difficile infections. Others are those who: Are over 65 years, Have serious illnesses, particularly those that can weaken the immune system, Are taking or who have recently taken antibiotics, Are taking medications to manage stomach acid, including those known as proton pump inhibitors (PPIs), Have had previous C. difficile infections. […] The only way to prevent developing an infection with C. difficile is by avoiding exposure to the bacteria. […] Reducing antibiotic overuse also reduces the risk of C. difficile infection. […] Doctors use specific antibiotics to treat C. difficile, but recommendations vary according to the severity of the infection, how often a patient has had the infection, and the availability of the recommended antibiotics. […] The CDC reports that about 20% of people experience a recurrence of C. difficile infection, sometimes repeatedly.

• #72 What is C. Diff? Symptoms, Treatment, & Support | Ferring Microbiome

  https://microbiome.ferring.com/patient-c-diff-infection/

  Around half a million infections are caused by C. diff every year. […] Up to 3 in 10 people who get a C. diff infection will get it again. […] After 1st recurrence, up to 6 in 10 people will get another C. diff infection. […] C. diff has forced people to limit or give up travel, outdoor activities or events, and even enjoying different types of food.

• #73 Clostridioides (Clostridium) Difficile Colitis: Background, Etiology, Pathophysiology

  https://emedicine.medscape.com/article/186458-overview

  Advanced age (65 y) and hospitalization (particularly sharing a hospital room with an infected patient, intensive care unit stays, and prolonged hospital stays) are known risk factors for infection with C difficile, as are comorbidities such as kidney disease, liver disease, and cardiovascular disease. […] Risk factors for recurrence of CDI include age older than 65 years, immune compromise, severe underlying illnesses, ongoing antibiotic treatments during CDI, and severe CDI on presentation. […] C difficile colitis results from a disturbance of the normal bacterial flora of the colon, colonization with C difficile, and release of toxins that cause mucosal inflammation and damage. […] C difficile forms heat-resistant spores that can persist in the environment for several months to years.

• #74 How to Prevent C. Diff Infection from Recurring

  https://www.healthline.com/health/preventing-c-diff-infection-from-recurring

  Studies have found that previous use of antibiotics increases the risk of recurrent C. diff infection. […] Since 2003, C. diff cases have become more frequent, harmful, recurring, and less responsive to treatment. This may be due to the emergence of a severe strain of C. diff known as NAP1/BI/027. […] This specific strain of C. diff produces more toxins than other strains. […] Risk factors such as older age, antibiotic use, gastric acid suppression, and a weakened immune system may increase the likelihood of C. diff recurrence.

• #75 Clostridioides (formerly Clostridium) difficile–Induced Diarrhea – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/clostridioides-formerly-clostridium-difficile-induced-diarrhea

  Antibiotic-induced changes in gastrointestinal flora are the dominant predisposing factors. […] C. difficile induced colitis may also follow use of certain antineoplastic medications. […] The organism secretes both an enterotoxin and a cytotoxin, typically referred to as toxins A and B. […] The main effect of the toxin is on the colon, which secretes fluid and develops characteristic pseudomembranes. […] If possibly causative antibiotics are being used, they should be stopped as soon as possible, or patients should be switched to an antibiotic regimen less likely to cause C. difficile induced diarrhea. […] Recurrence often results from reinfection (with the same or different strain), but some cases may involve persistent spores from the initial infection. […] For patients with recurrent infections, the ISDA guidelines suggest fidaxomicin rather than a standard course of vancomycin. […] A human monoclonal antibody, bezlotoxumab, binds to and neutralizes C. difficile toxin B; it can be used for prevention of recurrent C. difficile induced diarrhea along with standard-of-care treatment in patients who have had a recurrence within the last 6 months.

• #76 Clostridioides Difficile Infection (CDI) – IFFGD

  https://iffgd.org/gi-disorders/other-disorders/clostridium-difficile/

  CDI recurrence is the reappearance of diarrhea and other CDI symptoms after treatment ends following an initial improvement or response to the antibiotic used to treat the infection. […] Recurrences occur because the antibiotics that we use to treat CDI arent effective against the C. Difficile spore (the more resilient form of this bacterium that results in recurrence and transmission from person to person).

• #77 Health: Infectious Disease Epidemiology & Prevention Division: Clostridioides difficile

  https://www.in.gov/health/idepd/healthcare-associated-infections-and-antimicrobial-resistance-epidemiology/healthcare-associated-infections/clostridium-difficile/

  Clostridioides difficile (C. difficile or C. diff.), formerly known as Clostridium difficile, is an organism that causes life-threatening diarrhea and inflammation of the colon, known as pseudomembranous colitis. The primary risk factor for a Clostridioides difficile infection (CDI) is overuse of antibiotics. Those who have been recently hospitalized, are in a nursing home, are 65 years or older, or have a weakened immune system are also at increased risk. […] CDI is estimated to cause almost half a million illnesses in the United States each year, and an estimated 29,300 deaths. […] Individuals are 7 to 10 times more likely to acquire a CDI while taking antibiotics and during the month after. Thats because antibiotics that fight bacterial infections by killing bad germs can also get rid of the good germs that protect the body. […] Extended stays in healthcare settings, such as hospitals and nursing homes, increase risk for acquiring a CDI. One in 11 people over age 65, diagnosed with a healthcare-associated CDI, die within one month.

• #78 Biliary Tract Disorders, Gallbladder Disorders, & Gallstone Pancreatitis | ACG

  https://gi.org/topics/c-difficile-infection/

  C. difficile infection (CDI) is due to a toxin-producing bacteria that causes a more severe form of antibiotic associated diarrhea. […] CDI usually occurs when people have taken antibiotics that change the normal colon bacteria allowing the C. difficile bacteria to grow and produce its toxins. […] The major risk factor for CDI is taking antibiotics in the previous several weeks, but sometimes it occurs even without prior antibiotic use. […] Individuals can pick up C. difficile by ingesting spores that are all around in the environment, especially in hospitals. […] While antibiotics are effective in treating most cases of CDI, the symptoms recur after the end of treatment in 10-20% of cases. […] Current recommendations for the treatment of recurrent CDI include a vancomycin taper over six to eight weeks or fidaxomicin for ten days. […] Wise antibiotic policies, by using narrow-spectrum agents when directed and avoiding unnecessary use of broad-spectrum antibiotics, are key in the prevention of CDI.

• #79 Azthena logo with the word Azthena

  https://www.news-medical.net/health/What-is-Clostridium-difficile.aspx

  People with weak immune systems or a previous history of C. diff infection are also at higher risk. […] C. diff is a major source of healthcare-related infections, which spread mainly through the fecal-oral route. […] The spores formed by C. diff are passed in the feces of infected people and easily contaminate water, food, and other nearby objects/surfaces. […] The spores can survive in the environment for several weeks or months and cannot be destroyed by common chemical cleaning agents such as hand sanitizers. […] The infection is spread from person to person by touching the contaminated surfaces. […] Although C. diff infection can affect people with no obvious susceptibility, the presence of certain factors increases the risk of infection. […] One of the major risk factors is prolonged or recent consumption of broad-spectrum antibiotics or multiple antibiotics.

• #80 C. Difficile Infections – Brigham and Women’s Hospital

  https://www.brighamandwomens.org/about-bwh/quality/patient-safety-measures/c-difficile-infections

  Clostridium difficile, also known as C. difficile or C. diff, is a bacterium that causes diarrhea and can be fatal. […] People who have other illnesses or conditions requiring prolonged use of antibiotics, and the elderly, are at greater risk of acquiring this disease. […] C. diff is found in feces. People can become infected if they touch items or surfaces that are contaminated with the bacteria and then touch their mouth, eyes, or nose. […] Health care workers can spread the bacteria to patients or contaminate surfaces through hand contact.

• #81 Clostridioides Difficile – HAIAR

  https://www.vdh.virginia.gov/haiar/cdiff/

  Clostridioidesdifficile (C. difficile or C. diff) is a type of bacteria (germ) that causes diarrhea. Those at the highest risk for C. diff infection are older adults on antibiotics for a long time. People with gastrointestinal conditions or prior surgery are at risk. The same is true for those with weakened immune systems or other chronic health conditions. Frequent hospitalization also raises the risk for C. diff infection. […] Infection prevention is an important strategy to stop the transmission of C. difficile. This involves using antibiotics appropriately, implementing Contact Precautions, practicing good hand hygiene, and focusing on environmental cleaning and disinfection. […] C. diff is a major threat. According to CDCs 2019 Antimicrobial Resistance Threats Report, in 2017, there were an estimated 223,900 cases in hospitalized patients and 12,800 deaths in the United States.

• #82 How is C. Diff Spread? Understanding Transmission and Preventing Contagion of C. Difficile Infections

  https://www.qualityinsights.org/quality-quest/how-is-c.-diff-spread-understanding-transmission-and-preventing-contagion-of-c.-difficile-infections

  Clostridioides difficile, or C. diff, is a very contagious bacteria that can cause serious infections, especially in healthcare settings. […] C. diff is a germ that causes diarrhea and colitis (an inflammation of the colon). C. diff normally lives in the stomach and intestines, but under certain conditions it can grow and produce toxins that cause symptoms like severe diarrhea and stomach pain. […] Several factors increase the risk of C. diff infections, including: […] Taking antibiotics disrupts the natural balance of good and bad bacteria in the gut. People are 7 to 10 times more likely to get C. diff while on antibiotics and during the month after (Source: CDC). […] C. diff mainly spreads through contact with stool. The bacteria can get on surfaces, and if someone touches these contaminated items and then touches their mouth, they can swallow the bacteria and get infected. […] Yes, C. diff is very contagious. Coming into contact with surfaces or materials that have C. diff spores can spread the infection. It can also spread from person to person through close contact, especially if people dont follow good hygiene practices.

• #83

  https://www.aast.org/resources-detail/clostridium-difficile-infection-cdi

  The main symptom of Clostridium difficile infection is diarrhea, but fever, nausea, fatigue, dehydration, and abdominal discomfort may also occur. […] Treatment involves stopping any antibiotics that may have triggered the Clostridium difficile infection as soon as possible. There are also several antibiotics that target Clostridium difficile itself; these are metronidazole, vancomycin (only the oral form, the intravenous form is not effective), and fidaxomicin. These antibiotics are normally taken for 10-14 days. Clostridium difficile infection can recur after a course of treatment, and different regimens may be used to treat recurrent infection. […] While these severe cases are relatively rare, the overall rate of C. difficile infection in the United States is on the rise. This rate can be kept to a minimum by using antibiotics only when necessary, careful environmental and hand cleaning, and isolating patients with Clostridium difficile infection from those who are not infected, among other tactics. In addition to these prevention strategies, a variety of new treatment and prevention strategies are being researched, from new antibiotics, to fecal bacteriotherapy (stool transplant in which bacteria from one persons intestines are given to another person to help restore bacterial intestinal equilibrium), to antibodies against Clostridium difficile toxins, to vaccines. These will hopefully limit the impact of Clostridium difficile infection in the future.

• #84 C. diff infections and rethinking prevention

  https://www.astrazeneca.com/what-science-can-do/topics/disease-understanding/rethinking-prevention-of-recurrent-c-diff-infections.html

  This results in some patients requiring repeated courses of antibiotics to control the recurrent infections which increasingly disrupts the microbiome, leading to an intensive cycle and contributing to the increased risk of recurrence of C. diff. […] Antibiotics can be very effective at treating active CDIs, but unfortunately, they also have impact on the microbiome which make patients more susceptible to recurrences. […] Currently, the standard-of-care for recurrent CDIs is antibiotic treatment but there are some emerging strategies focused on prevention. […] When antibiotics alone fail to resolve the cycle of infection, an alternate strategy used to address the disruption to the microbiome is microbiota-based live biotherapeutic products (LBPs), which may be used to restore the balance in the microbiome and prevent the recurrence of C. diff.

• #85 Clostridioides (formerly Clostridium) difficile–Induced Diarrhea – Infectious Diseases – Merck Manual Professional Edition

  https://www.merckmanuals.com/professional/infectious-diseases/anaerobic-bacteria/clostridioides-formerly-clostridium-difficile-induced-diarrhea

  Antibiotic-induced changes in gastrointestinal flora are the dominant predisposing factors. […] C. difficile induced colitis may also follow use of certain antineoplastic medications. […] The organism secretes both an enterotoxin and a cytotoxin, typically referred to as toxins A and B. […] The main effect of the toxin is on the colon, which secretes fluid and develops characteristic pseudomembranes. […] If possibly causative antibiotics are being used, they should be stopped as soon as possible, or patients should be switched to an antibiotic regimen less likely to cause C. difficile induced diarrhea. […] Recurrence often results from reinfection (with the same or different strain), but some cases may involve persistent spores from the initial infection. […] For patients with recurrent infections, the ISDA guidelines suggest fidaxomicin rather than a standard course of vancomycin. […] A human monoclonal antibody, bezlotoxumab, binds to and neutralizes C. difficile toxin B; it can be used for prevention of recurrent C. difficile induced diarrhea along with standard-of-care treatment in patients who have had a recurrence within the last 6 months.

• #86 C. diff: Symptoms, Causes, Transmission, Treatment & More | Gastroenterologists located in Belmont Office, Belmont, Charlotte / Uptown , University Office, Charlotte Endoscopy Center, University Endoscopy Center and Pineville Office, Charlotte, C

  https://www.carolinadigestive.com/blog-post/c-diff-symptoms-causes-transmission-treatment-more

  Infections also can occur in younger individuals with other risk factors such as an autoimmune deficiency. […] C. diff infections are responsible for an increasing number of deaths, particularly in older Americans. […] The rise of drug-resistant bacteria is a growing problem, and the Clostridium difficile bacteria is no exception.

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