Abstract
Clostridium difficile infection (CDI) is the most common infectious cause of healthcareacquired diarrhoea. Approximately 15%–25% of all cases of antibiotic-associated colitis (AAC) are caused by C. difficile and this likelihood increases with the severity of disease, reaching 95%–100% among patients with documented antibiotic-associated pseudomembraneous colitis (PMC) (Bartlett, 1994). Since the initial report of C. difficile as the cause of AAC in 1978 (Larson et al., 1978), subsequent work has provided important information regarding risk factors, diagnosis and effective therapy. More recently, significant challenges have arisen due to increases in frequency and severity of disease, limitations of standard therapy and propensity for recurrence of infection. There has been an unanticipated increase in morbidity and mortality attributed to this disease, linked in part to the emergence of antimicrobial-resistance and the epidemic bacterial strain, BI/NAP1/ribotype 027 leading to a resurgence of CDI as a major cause of hospital-acquired infection.
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