Clostridium difficile Infection

Abstract

Clostridium difficile is a Gram-positive, anaerobic, spore-forming bacillus that is spread indirectly via the fecal-oral route through spores. Disturbance of gut microbiota due to antibiotic therapy causes abnormal proliferation of Clostridium difficile and toxin production, leading to the development of Clostridium difficile infection. A new, hyper-virulent strain of Clostridium difficile , NAP1/B1/027, has been implicated in Clostridium difficile outbreaks associated with increased morbidity and mortality since the early 2000s. In 2013, van Nood et al. reported that in patients with recurrent Clostridium difficile infection, fecal microbiota transplantation resulted in better treatment outcomes compared with conventional antibiotic treatment, which has attracted increased attention. Recently, monoclonal antibodies against toxin B, vaccines and a polystyrene binder of Clostridium difficile toxins have been developed for the treatment of Clostridium difficile infection. In this article, we will outline the epidemiology, pathophysiology, diagnosis and treatment of Clostridium difficile infection, and also describe the relationships between ulcerative colitis and Clostridium difficile infection.