Recurrent Clostridium difficile infection: From colonization to cure.
Clostridium difficile infection (CDI) is increasingly prevalent, dangerous and challenging to prevent and manage. Despite intense national and international attention the incidence of primary and of recurrent CDI (PCDI and RCDI, respectively) have risen rapidly throughout the past decade. Of major concern is the increase in cases of RCDI resulting in substantial morbidity, morality and economic burden. RCDI management remains challenging as there is no uniformly effective therapy, no firm consensus on optimal treatment, and reliable data regarding RCDI-specific treatment options is scant. Novel therapeutic strategies are critically needed to rapidly, accurately, and effectively identify and treat patients with, or at-risk for, RCDI. In this review we consider the factors implicated in the epidemiology, pathogenesis and clinical presentation of RCDI, evaluate current management options for RCDI and explore novel and emerging therapies.
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, United States. Electronic address: ksshield@bidmc.harvard.edu.
Kelsey
K
Shields
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Lowry Medical Office Building, Suite GB 110 Francis Street, Boston, MA 02215, United States. Electronic address: raraujo@bidmc.harvard.edu.
Roger V
RV
Araujo-Castillo
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, United States. Electronic address: ttheethi@bidmc.harvard.edu.
Thimmaiah G
TG
Theethira
Division of Infectious Diseases, Beth Israel Deaconess Medical Center, Harvard Medical School, Lowry Medical Office Building, Suite GB 110 Francis Street, Boston, MA 02215, United States. Electronic address: calonso@bidmc.harvard.edu.
Carolyn D
CD
Alonso
Division of Gastroenterology, Beth Israel Deaconess Medical Center, Harvard Medical School, 330 Brookline Ave., Boston, MA 02215, United States. Electronic address: ckelly2@bidmc.harvard.edu.
Ciaran P
CP
Kelly
D002353:Carrier State / Q000453:epidemiology* / Q000382:microbiology / Q000628:therapy; D016360:Clostridioides difficile / Q000302:isolation & purification*; D003015:Clostridium Infections / Q000453:epidemiology* / Q000382:microbiology / Q000473:pathology* / Q000628:therapy; D006801:Humans; D015994:Incidence; D012008:Recurrence; D012307:Risk Factors
Antibiotic; Fecal microbiota therapy; Infection control; Infectious diarrhea; Nosocomial infection; Toxin