Hospital-acquired Clostridium difficile diarrhoea and herd immunity

Clostridium difficile associated diarrhoea: diagnosis and treatment

“…In addition, the case mix on wards, and bays within wards, is important because of a potential herd immunity effect that can prevent epidemic outbreaks of C difficile associated diarrhoea 15. For example, if only a few patients on a ward have been exposed to antibiotics, most of those who have not been treated with antibiotics will retain their normal colonic bacterial flora and will not develop C difficile associated diarrhoea.…”

National Clostridium difficile Standards Group: Report to the Department of Health

“…Cefotaxime may also be associated with prolonged excretion of spores. 156 Comparisons of restrictive antibiotic formularies (piperacillin or benzyl penicillin, trimethoprim and, where necessary, gentamicin) with cefotaxime have demonstrated increased incidence of C. difficile colonisation and of CDAD in patients treated with cefotaxime, 157 and reduction in rates of CDAD. 158 Ludlam et al 159 describe similar results (C. difficile infection had dropped by 50%) when implementing a formulary recommending penicillin and ciprofloxacin for suspected infection with overall costs relating to CDAD reduced.…”

Ileal Smooth Muscle Motility Depression on Rabbit Induced by Toxin A from Clostridium difficile

“…During the last 20 years the number of diseases related to C. difficile, especially the nosocomial diarrhea, has been steadily growing [4][5][6][7][8][9]. The majority of the toxigenic strains of C. difficile, whose toxigenicity was described initially in 1935 [10], yield two types of exotoxins, toxin A (TxA) and toxin B (TxB), heat-labile proteins of 308-and 270-kDa MW respectively, both playing an active role on establishing or aggravating the clinical evolution of nosocomial diarrhea [7,11].…”