Epidemiological characteristics of hospital-acquired Clostridium difficile-associated diarrhea

Abstract

Clostridium difficile is an anaerobic bacterium which produces spores that can survive for a long time in the environment. The disease spectrum caused by Clostridium difficile ranges from diarrhea to toxic megacolon and collectively they are all called Clostridium difficileassociated disease (CDAD). Since 2000, this pathogen has demonstrated an increased propensity to cause more frequent and virulent illness that is often refractory to treatment. Clostridium difficile-associated disease is usually diagnosed following the demonstration of toxins A and/or B in stool samples. The most important risk factors are: age over 65 years, broad-spectrum antibiotics, severe underlying illness, nasogastric intubation, gastrointestinal surgery, and longer hospital stay. The measures of prevention and control of Clostridium difficile in the health care settings include the appropriate use of isolation precautions, hand hygiene, protective clothing, environmental cleaning and cleaning of medical equipment, good antibiotic stewardship, and specific measures during outbreaks.