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Clostridium difficile 

Clostridium difficile
Chapter:
Clostridium difficile
Author(s):

David W. Eyre

, and Mark H. Wilcox

DOI:
10.1093/med/9780198746690.003.0128
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date: 25 February 2021

Clostridium difficile (recently renamed as Clostridioides difficile) is a Gram-positive spore-forming anaerobic bacillus that is ubiquitous in nature, and particularly common in healthcare environments. Its spores are part of the colonic flora in about 2–3% of healthy adults, with colonization rates increasing, typically up to 10–20%, during hospitalization. Disease occurs when the organism shifts from quiescent spores to replicating vegetative cells with toxin (A and B) production; this happens when there is inhibition of the resident colonic flora (gut microbiome) by prescribed antibiotics, although cases can occur when no such precipitant is identified. C. difficile infection is now recognized as the most important bacterial enteric pathogen in wealthier countries, epidemics, and outbreaks of which are common, most notoriously now due to the ribotype 027 (NAP-1) strain that is associated with more severe disease and poor outcomes.

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