Definition
Clostridium difficile (C. difficile) infection is a bacterial infection that causes diarrhea and inflammation of the colon (colitis). It is primarily associated with antibiotic use and is a common cause of hospital-acquired infections.
Pathogenesis
C. difficile produces toxins that damage the intestinal wall, leading to inflammation. Antibiotic use disrupts the normal gut flora, allowing the bacterium to overgrow. Risk factors include prior antibiotic therapy, hospitalization, immunosuppression, and advanced age.
Diagnosis
Diagnosis is made by detecting C. difficile toxins in stool samples or through molecular methods (PCR). Endoscopy or CT scans may be used in severe cases to confirm pseudomembranous colitis and toxic megacolon.
Treatment
- Mild to moderate infection: Discontinuation of the responsible antibiotic and administration of specific antibiotic therapy (e.g., oral metronidazole or vancomycin).
- Severe infection: Oral vancomycin or fidaxomicin, along with supportive care (hydration, nutrition).
- Recurrent infections: Use of probiotics or fecal microbiota transplantation (FMT) to restore normal gut flora.
Early diagnosis and treatment are crucial to prevent complications such as toxic megacolon and bowel perforation. Preventive measures, including judicious use of antibiotics and strict hygiene protocols, are essential for reducing the spread of infection.