Clostridioides difficile : Choice of antibiotic ( NICE Summary )

Clostridioides difficile (C. difficile) infection (CDI) is a major healthcare-associated illness and has emerged as one of the most prevalent hospital-acquired infections in recent years.

C. difficile is a Gram-positive, anaerobic, spore-forming bacterium that can colonize the human intestinal tract. While it may exist harmlessly in some individuals, certain conditions can trigger its overgrowth, leading to infection.

• Cause: CDI typically arises when the normal gut microbiota is disrupted, most commonly due to the use of antibiotics. This disruption allows C. difficile to proliferate and produce toxins, leading to symptoms.

• Risk Factors: The main risk factors include advanced age, recent hospitalization, immunosuppression, and the use of proton pump inhibitors. These factors increase susceptibility by either compromising the immune system or altering the gut environment.

• Transmission: C. difficile is transmitted via the fecal-oral route. Its spores are highly resilient, capable of surviving on surfaces for prolonged periods, which contributes to its spread, particularly in healthcare settings.

• Symptoms: The clinical presentation of CDI can vary from mild diarrhea to severe and potentially life-threatening conditions like pseudomembranous colitis.

• Diagnosis: CDI is diagnosed based on clinical symptoms and confirmed through laboratory tests that detect C. difficile toxins or toxin genes...