Clostridioides difficile – a new name, the old problems with diagnosis and treatment

Abstract

Clostridium difficile was reclassified in 2016 under a new name of Clostridioides difficile. In 2021 to 2022, some changes were implemented into the main clinical guidelines on the diagnosis and treatment of infections caused by this pathogen. A two-step algorithm based on identification of C. difficile and then its toxins is still recommended for the diagnosis. The treatment regimens for the first episode and relapses of C. difficile-associated infection are based on metronidazole, vancomycin and fidaxomycin. Additional effectiveness of therapy has been associated with the use of microbiocenosis-oriented technologies aimed at restoration of the colon microbiota. In the Russian Federation, all widely applied diagnostic methods are available and all recommended antimicrobials, except fidaxomycin, as well as bezlotoxumab and fecal microbiota transplantation.