Abstract

SANCHEZ, Ana Lorena; OTERO, William  and  CAMINOS, Jorge E. Clostridium difficile associated disease: New threats of and old foe. Rev Col Gastroenterol [online]. 2008, vol.23, n.2, pp.142-159. ISSN 0120-9957.

Clostridium difficile-associated disease (CDAD) actually is an important health problem world wide with increased morbidity and mortality, especially among the elderly population. The CDAD is increasingly being reported in many regions throughout the world.. Since 2002, outbreaks of a fluoquinolone-resistant strain of C. difficile (BI/NAP1/027) have been predominantly associated with these outbreaks. Changes in the epidemiology of CDAD include the emergence of new at risk populations and the increased incidence of the disease. Antibiotics, especially those with a broad spectrum, often trigger the infection; hence the use of unnecessary antibiotics should be avoided. The medical treatment is with metronidazole or vancomycin. Severe cases may require bowel resection. Chronic relapsing cases require a prolonged course of antibiotics, immunoglobulin and occasionally, feces enema. This review provides a comprehensive update on epidemiology, pathogenesis and management of C. difficile infection.

Keywords : Clostridium difficile; diarrea; vancomycin; metronidazole; hypervirulent strains; risk factors.

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