Clostridium Difficile Clinical Information
Risk Factors for CDI
- Advanced age (>65 years)
- Recent antimicrobial exposure (within 3 months of symptom onset)
- Clindamycin, beta-lactams, cephalosporins have historically been associated with CDI, though all antibiotic classes have been implicated
- Brief antibiotic exposure may result in CDI, though prolonged exposure or use of more than one antibiotic may further increase risk
- Recent hospitalization or long-term care facility admission
- Other potential contributing factors
- Serious underlying illness; immunocompromising conditions
- Use of proton-pump inhibitors (causing alteration in stomach acidity) may be considered a risk factor
Signs and Symptoms
- Watery liquid diarrhea 3-15 times per day is the most common symptom
- Other symptoms for mild-moderate disease include:
- Loss of appetite
- Abdominal pain/tenderness
- Complications of severe disease
- Pseudomembranous colitis
- Toxic megacolon
- Colon perforation
- Death (rare)
- C. difficile is a fastidious anaerobe that dies rapidly in its vegetative state.
- C. difficile produces spores that can remain in the environment for days to months.
- Any environmental surface can transmit C. difficile spores which are highly resistant to cleaning and disinfection measures.
- Transmission of C. difficile occurs through the fecal-oral route
- CDI should be considered in any patient with watery liquid diarrhea or abdominal pain following:
- antibiotic exposure
- exposure to a healthcare setting within the past 3 months
- Due to the changing epidemiology of C. difficile, consider CDI in patient with diarrhea lasting longer than three days with fever and/or abdominal pain in the absence of recent antibiotic use or healthcare exposure.
- In some situations, C. difficile may be diagnosed through the identification of pseudomembranes identified by endoscopy.
Updated Tuesday, 10-Jan-2012 12:22:33 CST