Clostridioides (formerly Clostridium) difficile infection is commonly associated with antibiotic treatment and is one of the most common nosocomial infections
Signs and Symptoms
Symptoms usually start on days 2-3 of antibiotic treatment, but may also occur up to 8-12 weeks after discontinuation of antibiotics
Acute diarrhea in an inpatient of ≥3 loose stools in ≤24 hours and in an outpatient of ≥3 loose stools in 24 hours for at least 2 consecutive days or ≥8 loose stools in 48 hours
Worsening of chronic diarrhea
Increasing output from an ostomy site after a recent antibiotic use
Severe pain and abdominal distension after an episode of diarrhea with no current stool output may indicate ileus or toxic megacolon
Risk Factors
Antibiotic therapy
Antibiotics most commonly implicated are the cephalosporins, monobactams, carbapenems, fluoroquinolones, beta-lactamase inhibitor combinations and Clindamycin
Macrolides, aminoglycosides, sulfonamides and other penicillins are less commonly involved
Prolonged antibiotic administration increases the risk of C difficile colitis, but even a brief exposure to a single antibiotic may cause disease
Intensive care unit (ICU) admission
Prolonged stay in the hospital
Sharing a hospital room with a C difficile-infected patient
Recent surgery
Advanced age
Residing in a nursing home or long-term care facility
