Current management of Clostridioides (Clostridium) difficile infection in adults: a summary of recommendations from the 2017 IDSA/SHEA clinical practice guideline

Abstract

of C. difficile infection in adults 189 point in their lives, if not multiple times. Most of the time, it results in transient, asymptomatic colonization. When C. difficile causes a disease, as in CDI, it can range from mild self-limited diarrhea to fulminant colitis with shock. New cases can be defined by location and timing of symptom onset to aid in epidemiologic studies and prevention efforts (TABLE 1). 3 After the year 2000, CDI-related morbidity, mortality, and costs have increased dramatically. Before 2000, the mortality rate attributable to CDI was less than 1.5%, while after 2000, this increased to between 4.5% and 5.7% during endemic periods and up to 16.7% during epidemic periods. 4 There were also dramatic increases in the incidence of CDI. According to the Centers for Disease Control and Prevention in the United States, close to 500 000 cases were diagnosed in 2011, with about 29 000 associated deaths and an estimated $4.8 billion in unnecessary inpatient costs. 5,6 These changes in CDI epidemiology coincided with the identification of a new predominant strain known as 027/NAP1/BI (the name varies based on the type of molecular typing technique, referred to as ribotype 027 from here onwards). This strain is highly fluoroquinolone

<i>Clostridioides difficile</i> infection in coronavirus disease 2019: an underestimated problem?

“…Patients usually present with leukocytosis, malaise, abdominal cramping, pain, and watery diarrhea [29]. Unfortunately, isolated gastrointestinal symptoms might be present in the course of COVID-19 in up to 10% of patients [30].…”

Impact of Updated Clinical Practice Guidelines on Outpatient Treatment for Clostridioides difficile Infection and Associated Clinical Outcomes

“…Third, the CDI cases included in these analyses were nonsevere by virtue of needing to limit the population to patients treated in the outpatient setting based on prescription data availability. The greatest benefit of vancomycin over metronidazole is for initial cure of more severe CDI episodes [ 16 ].…”

The development of live biotherapeutics against Clostridioides difficile infection towards reconstituting gut microbiota

“…According to the 2017 IDSA/SHEA clinical practice guidelines, FMT is recommended for patients with multiple recurrences of CDI. 43 The development of FMT therapeutics is riding on the crest of a wave. Most of the registered clinical trials in the United States targeting gut microbiome to treat CDI or recurrent CDI are FMT ( Table 3 ).…”