Clostridium difficle (C. diff.): A Review of Risk Factors, Physiological Effects, Prevention and Treatment Options

The human gastro-intestinal track (GIT) is a tubular digestive factory measuring 25 feet and consists of the mouth, the stomach, the liver, the pancreas, the small and large intestines and the rectum. Over 500 species of bacteria reside along the GIT. In addition to aiding in human digestion, these resident bacteria control the overgrowth of pathogenic bacteria in the GIT. Variations in GIT pH, nutrients, etc., affect the viability and the actions of these bacteria. C. diff.  is a gram-positive, spore-forming bacillus that is responsible for the development of antibiotic-associated diarrhea and pseudomembranous colitis. C. diff.  infection occurs following ingestion or external exposure to spores and depends almost completely on prior antibiotic treatment that kills endogenous microorganisms of the intestine that normally suppress the growth of C. difficile.  Acquisition of C. diff. occurs primarily in the heath care setting.  The organism has been cultured from bed rails, floors, windowsills, toilets, and the hands of care givers. The organisms can persist in the hospital rooms for up to 40 days after infected patients have been discharged.  The rate of C. diff. acquisition is estimated at 13% in patients with hospital stays of up to 2 weeks and 50 % in those with stays longer than 4 weeks. Patients who share a room with a C. diff-positive patient acquire the organisms after ~ 3.2 days, compared with 18.9 days for other patients.  The purpose of this review is to supply the clinician with valuable information on various aspects of C. diff. (risk factors. physiological effects, prevention, treatment options, etc.).  As a result, the clinician may have a broader understanding of this important pathogen in terms of prevention and treatment that could result in a benefit to the patient.