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Clin Colon Rectal Surg 2020; 33(02): 049-057
DOI: 10.1055/s-0040-1701229
Review Article
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Clostridium difficile Infection: An Epidemiology Update

Ana C. De Roo
1   Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
2   Department of Surgery, University of Michigan, Ann Arbor, Michigan
,
Scott E. Regenbogen
1   Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan
2   Department of Surgery, University of Michigan, Ann Arbor, Michigan
› Author Affiliations
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Publication History

Publication Date:
25 February 2020 (online)

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Abstract

Clostridium (reclassified as “Clostridioides”) difficile infection (CDI) is a healthcare-associated infection and significant source of potentially preventable morbidity, recurrence, and death, particularly among hospitalized older adults. Additional risk factors include antibiotic use and severe underlying illness. The increasing prevalence of community-associated CDI is gaining recognition as a novel source of morbidity in previously healthy patients. Even after recovery from initial infection, patients remain at risk for recurrence or reinfection with a new strain. Some pharmaco-epidemiologic studies have suggested an increased risk associated with proton pump inhibitors and protective effect from statins, but these findings have not been uniformly reproduced in all studies. Certain ribotypes of C. difficile, including the BI/NAP1/027, 106, and 018, are associated with increased antibiotic resistance and potential for higher morbidity and mortality. CDI remains a high-morbidity healthcare-associated infection, and better understanding of ribotypes and medication risk factors could help to target treatment, particularly for patients with high recurrence risk.

Keywords

Clostridium difficile - healthcare associated infection - proton pump inhibitor - statins - ribotype
 

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