Anaerobic spore-forming, gram-positive bacilli, box-car shaped.
Nosocomial more common than community-onset diarrhea usually after taking antibiotics.
Can occur in outbreaks.
Recurrence is very common; therefore, previous history of C. difficile is a risk factor.
Risk factors include: advanced age, hospitalization, prior or concomitant systemic antibacterial therapy, cancer chemotherapy, gastrointestinal surgery. Antacids, especially proton-pump inhibitors, also increase risk.
Wide range of symptoms possible
Profuse, watery diarrhea
Pseudomembranous colitis or toxic megacolon
Probiotics may be helpful.
In refractory cases, stool transplants have been effective.
Limit the number of systemic antibiotics used and duration of antibiotic therapy.