Epidemiology

Clostridium difficile is a spore-forming obligate anaerobic bacillus that causes pseudomembranous colitis. C. difficile was originally identified as an enteric human pathogen in 1978. The incidence of this disease has been increasing in recent years, coincident with the increased spectrum of antibiotics in use throughout the United States. Three different syndromes have been described: neonatal pseudomembranous enterocolitis, postoperative pseudomembranous enterocolitis, and antibiotic-associated pseudomembranous colitis. Recent antibiotic use, gastrointestinal surgery or manipulation, severe underlying medical illness, and advancing age have all been identified as risk factors for developing pseudomembranous colitis. Transmission of the organism has been implicated from direct human contact as well as contact with inanimate objects (commodes, telephones, rectal thermometers). C. difficile is the most common enteric pathogen associated with nosocomial diarrhea.^

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