title: Update on Clostridium difficile infection.
abstract: OBJECTIVE
  This review summarizes the most recent epidemiological data and advances in research into the pathogenesis, diagnosis and treatment of Clostridium difficile infection (CDI).
  
  
  RESULTS
  The epidemiology of CDI has changed with the emergence of hypervirulent strains. CDI rates have increased in the community, in children and in patients with inflammatory bowel disease. Although the North American pulsed-field gel electrophoresis type 1, restriction endonuclease analysis group BI, PCR ribotype 027 (NAP1/BI/027) strain remains prevalent in North America, surveillance suggests that it is decreasing in Europe. A similar strain, PCR ribotype 078, is emerging which is associated with community-associated CDI and has been isolated in animals and food products. The Society for Healthcare Epidemiology of America and the Infectious Diseases Society of America have published new guidelines on the epidemiology, diagnosis, treatment, infection control and environmental management of C. difficile. Several novel therapies for CDI are at different stages of development. There have been promising trial results with fidaxomicin, a novel antibiotic for the treatment of CDI and monoclonal antibodies against toxins A and B, which have been shown to significantly reduce CDI recurrence rates.
  
  
  CONCLUSIONS
  Major advances have been made in our understanding of the spread and pathogenesis of C. difficile and new treatment options are becoming available.
authors.affiliation: Department of Medicine for the Older Person, Mater Misericordiae University Hospital, Ireland.
authors.forename: Caoilfhionn
authors.initials: C
authors.lastname: O'Donoghue
authors.forename: Lorraine
authors.initials: L
authors.lastname: Kyne
mesh_terms: D016360:Clostridioides difficile / Q000472:pathogenicity*; D004761:Enterocolitis, Pseudomembranous / Q000175:diagnosis / Q000453:epidemiology / Q000628:therapy; D006801:Humans