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Community-acquired Clostridium difficile infection: an increasing public health threat

Authors Gupta A, Khanna S

Received 27 January 2014

Accepted for publication 14 February 2014

Published 17 March 2014 Volume 2014:7 Pages 63—72

DOI https://doi.org/10.2147/IDR.S46780

Checked for plagiarism Yes

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Video abstract presented by Arjun Gupta.

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Arjun Gupta, Sahil Khanna

Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA

Abstract: There has been a startling shift in the epidemiology of Clostridium difficile infection over the last decade worldwide, and it is now increasingly recognized as a cause of diarrhea in the community. Classically considered a hospital-acquired infection, it has now emerged in populations previously considered to be low-risk and lacking the traditional risk factors for C. difficile infection, such as increased age, hospitalization, and antibiotic exposure. Recent studies have demonstrated great genetic diversity for C. difficile, pointing toward diverse sources and a fluid genome. Environmental sources like food, water, and animals may play an important role in these infections, apart from the role symptomatic patients and asymptomatic carriers play in spore dispersal. Prospective strain typing using highly discriminatory techniques is a possible way to explore the suspected diverse sources of C. difficile infection in the community. Patients with community-acquired C. difficile infection do not necessarily have a good outcome and clinicians should be aware of factors that predict worse outcomes in order to prevent them. This article summarizes the emerging epidemiology, risk factors, and outcomes for community-acquired C. difficile infection.

Keywords: community acquired infection, Clostridium difficile, epidemiology, risk factors, outcome

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