"PREVENTIVE MEASURES FOR CLOSTRIDIOIDES DIFFICILE INFECTIONS IN HOSPITAL SETTINGS: A LITERATURE REVIEW OF RECOMMENDATIONS AND NOVEL TARGETED STRATEGIES"

"Introduction: Clostridioides difficile infections (CDIs) are one of the most frequent hospital- acquired infections. The microorganism is considered the leading cause of acute diarrheal syndrome after the use of antibiotics, in Romania. Objective: The main objective is to provide a comprehensive review summarizing existing evidence regarding how CDIs can be prevented. Methods: We screened PubMed, PubMed Central (PMC), ScienceDirect, and Google Scholar, clinical trials in different phases, and several national and international guidelines on the subject of prevention of C. difficile infections, using specific keywords. Results: We divided the recommendations into the following categories: good practice, strong, weak, and no recommendations, while novel strategies are detailed separately. The newly available treatment options have been analyzed as well as the ongoing efforts to obtain novel therapies, such as synthetic biologics that curb C. difficile colonization and proliferation, the association between ribaxamase (a poorly absorbable beta-lactamase) and parenteral broad-spectrum antibiotics, antisense molecules with potent anti-difficile activity or antibody-based therapeutics. Conclusions: At the time of submission, there is no globally accepted guideline in regard to the management of patients with Clostridioides difficile infections. Conventional strategies have lowered the incidence of CDIs but seem insufficient to eradicate hospital-acquired C. difficile infections. The challenge of CDIs has pushed researchers towards novel approaches, which may be the solution for many difficult-to-treat infections. Keywords: Clostridioides difficile, CDI, ribotype 027, post-antibiotic infection, pseudomembranous colitis, toxic megacolon"