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Clostridium difficile: Responding to a New Threat From an Old Enemy

L. Clifford McDonald , MD, FACP
Infection Control and Hospital Epidemiology
Vol. 26, No. 8 (August 2005), pp. 672-675
DOI: 10.1086/502600
Stable URL:
Page Count: 4
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Clostridium difficile: Responding to a New Threat From an Old Enemy
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EXCERPT It has been 70 years since the initial description of Clostridium difficile and nearly 30 years since the discovery of its role in antibiotic‐associated colitis.1,2 During the past three decades, we have learned much about this organism, including the function and regulation of its principal toxins, A and B, and their role in disease, ranging from the relatively mild forms of pseudomembranous colitis to severe toxic megacolon, sepsis, and even death.3,4 We also have begun to appreciate the function of the host’s immune system in the prevention of and recovery from C. difficile–associated disease (CDAD) and in the prevention of recurrent disease.5,6 The role of C. difficile spores, which can contaminate the patient care environment, fomites, and the hands of healthcare workers, in transmission of disease in healthcare settings is now becoming clear.7‐9 Finally, it appears likely that the use of particular antimicrobials directed at other pathogens, coupled with intrinsic or acquired resistance in C. difficile, may play an important role in epidemic hospital outbreaks.10

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