Clostridium difficile

Clostridium difficile is a major cause of antibiotic-associated diarrhea an d colitis. The incidence of infection with this organism is increasing in h ospitals worldwide, consequent to the widespread use of broad-spectrum anti biotics. Pathogenic strains of C. difficile produce two protein exotoxins, toxin A and toxin B, that cause colonic mucosal injury and inflammation. Ma ny patients who are colonized are asymptomatic, and recent evidence indicat es that diarrhea and colitis occur in those individuals who lack a protecti ve antitoxin immune response. In patients who do develop symptoms, the spec trum of C. difficile disease ranges from mild diarrhea to fulminant pseudom embranous colitis. Prevention of nosocomial C. difficile infection involves judicious use of antibiotics and multidisciplinary infection control measu res to reduce environmental contamination and patient cross-infection, Ulti mately, active or passive immunization against C. difficile may be an effec tive means of controlling the growing problem of nosocomial C. difficile di arrhea and colitis.