Abstract
Clostridium difficile (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 (testing for clostridial toxins A a B; testing for clostridial glutamatdehydrogenase, anaerobic cultivation with specific media, or PCR detection of genes for production of clostridial toxins. The alternative way to assessing the etiology is coloscopic examination; the disease is ascertained if typical pseudomembrane isles are present in the bowel mucosa.
Optimal treatment depends on severity of the disease and on the risk of recurrence. Metronidazol, vancomycin and fidaxomicin are used as basic drugs.
Faecal transplantation 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 shoud 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.