Clostridium difficile: an emerging epidemic in nursing homes.

Clostridium difficile is currently recognized as the most common cause of nosocomial infectious diarrhea in the nursing home setting. Data from the Centers for Disease Control and Prevention confirm that the incidence of C. difficile has doubled in recent years and accounts for approximately 3 million cases of diarrhea and colitis each year. Overall mortality associated with C. difficile infectious diarrhea is estimated to be 17% but is even higher in the older adult population. Older adults are at higher risk for this infection because of age-related changes in fecal flora and host defenses, as well as the presence of multiple comorbidities. Nursing staff, nurse practitioners, and physicians must become knowledgeable in the treatment and management of C. difficile before it reaches epidemic proportions. Diligent infection control practices, health care worker education, family education, and identification of new prevention and control strategies are vital to limiting its spread.