Clostridioides difficile Infection

David B. Stewart, MD, FACS, FASCRS

Clostridioides difficile infection (CDI) is the most common nosocomial bacterial infection in the United States, which makes it a joint health care issue for both medical and surgical physicians. CDI is also a focus of intense research to understand its pathogenesis and to leverage this information toward improved treatments for CDI. This latter point represents a major and persistent treatment gap in the care of CDI patients; despite the development of new antibiotics, and despite the efficacy of fecal microbiota transplants, at a population level adverse disease outcomes, such as recurrence, persistence, and mortality continue to drive the over 4 billion dollars in annual health care costs attributed to this infection. The relationship between gut ecology and the development of CDI marks this disease as being of great interest to microbiome researchers, and the falling costs of sequencing have led to increased availability of the tools to study both the clinically relevant and the scientifically fascinating aspects that make this disease so challenging to prevent and to cure. In this edition of Clinics in Colon and Rectal Surgery, the authors provide a review of all relevant aspects of the clinical care of CDI. These manuscripts also introduce the reader to how the gut microbiome, the host immune response, and the bacteria's ability to survive through sporulation are responsible for the clinical challenges faced in relieving the burden CDI represents to patients. I am particularly proud of this edition of Clinics in Colon and Rectal Surgery, as I believe that this edition provides clinicians a thorough appraisal of the most current views regarding this disease.

I want to thank the authors who contributed their time and efforts to this edition, as well as thanking Dr. Steele for the opportunity to serve as a guest editor for this issue of Clinics in Colon and Rectal Surgery.