Clostridium difficile — More Difficult Than Ever

Because of mutations in this opportunistic pathogen, infections with C. difficile have become both more prevalent and more virulent. This article summarizes recent changes in the epidemiology of this infection and explains what is known about the changes in disease severity and the response to therapy. The authors discuss the use of new antibiotics, probiotics, immunotherapy, and even bacteriotherapy. Infections with C. difficile have become both more prevalent and more virulent. This article summarizes recent changes in the epidemiology of this infection and explains what is known about the changes in disease severity and the response to therapy. In 1935, Hall and O'Toole first isolated a gram-positive, cytotoxin-producing anaerobic bacterium from the stool of healthy neonates. 1 They named it Bacillus difficilis to reflect the difficulties they encountered in its isolation and culture. We now face the opposite problem of being unable to contain the growth and spread of the same bacterium, now called Clostridium difficile, which is a frequent cause of infectious colitis, usually occurring as a complication of antibiotic therapy, in elderly hospitalized patients. In this article we review recent changes in the epidemiology of C. difficile infection, discuss changes in disease severity and response to therapy, . . .