Clostridioides difficile

(Previously Clostridium difficile)

Gram Stain

  • Gram positive bacilli (anaerobic)

Clinical Significance

This organism is found in the environment (soil, water, human and animal feces) and in food products such as processed meats.

It can cause symptoms ranging from mild to severe diarrhea and intestinal conditions such as pseudomembranous colitis. Severe cases can lead to bowel perforation, sepsis, and even death. 

This organism can also be found in the gut of healthy adults and up to 30% of healthy neonates.

Only strains of C. difficile that carry the genetic information for enterotoxin (Tox A) and cytotoxin (ToxB) are capable of causing disease.

 

Usual Susceptibility Pattern

This organism is susceptible to metroniodazole, vancomycin, and fidaxomicin.

 

Empiric Therapy
Mild initial infection in low risk patients:
Metronidazole
Moderate/severe or recurrent infection or high risk patients:
Vancomycin PO