Abstract
Clostridium difficile infection (CDI) is a disease of various severity, manifesting itself from mild diarrhea to life-threatening paralytic ileus, painful distension of the large bowel, and sepsis. The other possible manifestation of the disease is recurrent colitis that can exhaust the patient.
For establishing the diagnosis, the patient 's stool should be examined with two or three different microbiological methods. Immunochemic testing for presence of clostridial toxins A and B shows good specificity but poor sensitivity.
Thus it must be combined with other methods: stool testing for glutamat-dehydrogenase (clostridial antigen), anaerobic cultivation, or PCR detection. The alternative way to assessing the etiology is coloscopic examination; the disease is ascertained if typical pseudomembrane isles are present in the bowel mucosa.
The basic medication against CDI remains metronidazol (in oral or parenteral form) and/or vancomycin (given by oral or rectal route). Fidaxomicin seems a promising drug.
Stool transplant via nasojejunal sonde is effective in recurrent course of the disease. In the hospital setting, patients suffering from CDI should be isolated for the whole period of diarrhea.
Surveillance rules also should be applied, together with early treatment of symptomatic patients and prevention of speading the infection. Higher incidence of CDI in a ward implies that revision of the local antibiotic prescription habits should be performed.