Clostridium difficile: a reemerging pathogen.

Clostridium difficile is an important health care-associated pathogen, especially among older adults who are disproportionately affected by C difficile infection (CDI). During the current decade, there has been a dramatic increase in the incidence and severity of health care-associated CDI. These clinically relevant changes are temporally associated with the emergence of a hypervirulent strain of C difficile that has now become widely disseminated. The increased burden of disease and incidence of adverse patient outcomes and the limitations of currently available therapeutic options highlight the importance of preventing transmission of C difficile within health care facilities, including long-term care facilities where unique challenges for infection prevention may be present. Prevention efforts should address patient-specific and facility-related risk factors. This article reviews the epidemiology, diagnosis, treatment, and prevention of C difficile infection.