Risk factors in etiopathogenesis, diagnosis and therapy of clinically significant Clostridium difficile infection

Abstract:

Clostridium difficile infection is the first cause of diarrhea in patients with risk factors. It is important to identify risk factors in patients who might develop the disease after being exposed to the bacteria. The most frequently mentioned risk factors are the use of broad-spectrum antibiotics, chemotherapy, serious underlying diseases, older age, gastrointestinal surgery and the use of a nasogastric tube. Timely diagnosis is crucial in order to quickly and reliably detect the presence of toxin A and/or B which cause the disease. Studies also mention the use of two different tests simultaneously/ parallel due to higher sensitivity and specificity (proof of glutamate dehydrogenase and toxin) in clinically significant infections, and molecular methods can be used as well. It is necessary to treat patients with diarrhea associated to Cl. difficile infection with appropriate antibiotics (primarily oral metronidazole) in order to prevent complications. It is important to mention that, in order to prevent epidemics, a multidisciplinary approach and close cooperation whilst strictly following the guidelines of the Committee for Hospital Infections, is necessary. 

Key words:
Clostridium difficile infection; diagnosis; risk factors; therapy