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Clostridium difficile Clinical Information
Risk Factors for CDI
- Advanced age (>65 years)
- Recent antimicrobial exposure (within previous 3 months)
- All antibiotics increase the risk of CDI; clindamycin, beta-lactams, fluoroquinolones, and cephalosporins are most often associated with CDI
- Even 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 (within previous 3 months)
- Other potential contributing factors
- Serious underlying illness; immunocompromising conditions
- Use of proton-pump inhibitors (causing alteration in stomach acidity)
Signs and Symptoms
- Watery liquid diarrhea 3-15 episodes 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)
- Transmission of C. difficile occurs through the fecal-oral route
- C. difficile spores can be transmitted to patients via the hands of healthcare personnel who have touched a contaminated surface or item
- Any environmental surface can transmit C. difficile spores which are highly resistant to cleaning and disinfection measures.
- C. difficile is a fastidious anaerobe that dies rapidly in its vegetative state
- C. difficile spores can remain in the environment for days to months and are highly resistant to cleaning and disinfection measures
- CDI should be considered in any patient with watery diarrhea or abdominal pain following:
- antibiotic exposure within previous 3 months
- 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 3 days with fever and/or abdominal pain in the absence of recent antibiotic use or healthcare exposure.
- C. difficile may also be diagnosed through the endoscopic identification of pseudomembranes.
Updated Friday, January 10, 2014 at 02:06PM