Published online Aug 25, 2016. doi: 10.5495/wjcid.v6.i3.28
Peer-review started: March 24, 2016
First decision: April 15, 2016
Revised: May 5, 2016
Accepted: May 31, 2016
Article in press: June 2, 2016
Published online: August 25, 2016
Processing time: 154 Days and 0.6 Hours
Clostridium difficile infection (CDI) is the most common nosocomial infection in the United States and is associated with a high mortality. One quarter of patients treated for CDI have at least one recurrence. Spore persistence, impaired host immune response and alteration in the gastrointestinal microbiome due to antibiotic use are factors in recurrent disease. We review the etiology of recurrent CDI and best approaches to management including fecal microbiota transplantation.
Core tip: Recurrent Clostridium difficile infection (RCDI) is common and can be difficult to treat. Clostridia spores transmit disease. They are ubiquitous and hard to eradicate. The composition of the gut microbiome plays an essential yet poorly understood role in maintaining overall health, and in protecting against Clostridium difficile (C. difficile) infection. Antibiotic induced dysbiosis of the microbiome is a key contributor to RCDI. Here we review how C. difficile spores and alterations in the microbiome contribute to RCDI.