BACKGROUND: Clostridium difficile infection (CDI) has increased in incidence and severity over the past quarter century, and is now considered a major cause of healthcare-associated infections. METHODS: Review of the pertinent English-language medical literature. RESULTS: There has been a substantial change in the management of CDI. The emergence of the NAP1/BI/O27 strain in the early to mid-2000s has been associated with more severe forms of CDI. The pathophysiology, epidemiology, clinical manifestations and diagnosis, as well as new strategies for medical and surgical management are discussed in this review. CONCLUSIONS: Clostridium difficile infection can range from benign diarrhea to severe disease associated with substantial morbidity and mortality. Treatment modalities vary based on disease severity and timing of onset. The mainstay of medical treatment remains metronidazole and oral/rectal vancomycin. New management strategies are evolving, including adjunctive treatments such as monoclonal antibodies, vaccination, and fecal transplant. In patients with severe disease or clinical deterioration, early surgical consultation for total colectomy or loop ileostomy may be life-saving. Infection control measures are vital to mitigating the spread of CDI.
BACKGROUND:Clostridium difficile infection (CDI) has increased in incidence and severity over the past quarter century, and is now considered a major cause of healthcare-associated infections. METHODS: Review of the pertinent English-language medical literature. RESULTS: There has been a substantial change in the management of CDI. The emergence of the NAP1/BI/O27 strain in the early to mid-2000s has been associated with more severe forms of CDI. The pathophysiology, epidemiology, clinical manifestations and diagnosis, as well as new strategies for medical and surgical management are discussed in this review. CONCLUSIONS:Clostridium difficile infection can range from benign diarrhea to severe disease associated with substantial morbidity and mortality. Treatment modalities vary based on disease severity and timing of onset. The mainstay of medical treatment remains metronidazole and oral/rectal vancomycin. New management strategies are evolving, including adjunctive treatments such as monoclonal antibodies, vaccination, and fecal transplant. In patients with severe disease or clinical deterioration, early surgical consultation for total colectomy or loop ileostomy may be life-saving. Infection control measures are vital to mitigating the spread of CDI.
Authors: Hisham Hussan; Emmanuel Ugbarugba; Michael T Bailey; Kyle Porter; Bradley Needleman; Sabrena Noria; Benjamin O'Donnell; Steven K Clinton Journal: Obes Surg Date: 2018-07 Impact factor: 4.129
Authors: Massimo Sartelli; Mark A Malangoni; Fikri M Abu-Zidan; Ewen A Griffiths; Stefano Di Bella; Lynne V McFarland; Ian Eltringham; Vishal G Shelat; George C Velmahos; Ciarán P Kelly; Sahil Khanna; Zaid M Abdelsattar; Layan Alrahmani; Luca Ansaloni; Goran Augustin; Miklosh Bala; Frédéric Barbut; Offir Ben-Ishay; Aneel Bhangu; Walter L Biffl; Stephen M Brecher; Adrián Camacho-Ortiz; Miguel A Caínzos; Laura A Canterbury; Fausto Catena; Shirley Chan; Jill R Cherry-Bukowiec; Jesse Clanton; Federico Coccolini; Maria Elena Cocuz; Raul Coimbra; Charles H Cook; Yunfeng Cui; Jacek Czepiel; Koray Das; Zaza Demetrashvili; Isidoro Di Carlo; Salomone Di Saverio; Irina Magdalena Dumitru; Catherine Eckert; Christian Eckmann; Edward H Eiland; Mushira Abdulaziz Enani; Mario Faro; Paula Ferrada; Joseph Derek Forrester; Gustavo P Fraga; Jean Louis Frossard; Rita Galeiras; Wagih Ghnnam; Carlos Augusto Gomes; Venkata Gorrepati; Mohamed Hassan Ahmed; Torsten Herzog; Felicia Humphrey; Jae Il Kim; Arda Isik; Rao Ivatury; Yeong Yeh Lee; Paul Juang; Luis Furuya-Kanamori; Aleksandar Karamarkovic; Peter K Kim; Yoram Kluger; Wen Chien Ko; Francis D LaBarbera; Jae Gil Lee; Ari Leppaniemi; Varut Lohsiriwat; Sanjay Marwah; John E Mazuski; Gokhan Metan; Ernest E Moore; Frederick Alan Moore; Carl Erik Nord; Carlos A Ordoñez; Gerson Alves Pereira Júnior; Nicola Petrosillo; Francisco Portela; Basant K Puri; Arnab Ray; Mansoor Raza; Miran Rems; Boris E Sakakushev; Gabriele Sganga; Patrizia Spigaglia; David B Stewart; Pierre Tattevin; Jean Francois Timsit; Kathleen B To; Cristian Tranà; Waldemar Uhl; Libor Urbánek; Harry van Goor; Angela Vassallo; Jean Ralph Zahar; Emanuele Caproli; Pierluigi Viale Journal: World J Emerg Surg Date: 2015-08-20 Impact factor: 5.469
Authors: John T Denny; Enrique Pantin; Antonio Chiricolo; James Tse; Thomas Jan; Mohammad Chaudhry; Sylviana Barsoum; Angela M Denny; Denes Papp; Sharon L Morgan Journal: J Clin Med Res Date: 2015-02-09