Clostridioides difficile infections Shinya HASEGAWA 1 , Yasuaki TAGASHIRA 1 , Hitoshi HONDA 1 1Division of Infectious Diseases Tokyo Metropolitan Tama Medical Center pp.75-85
Published Date 2019/1/1
DOI https://doi.org/10.11477/mf.3102200600
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Clostridioides difficile infections (CDI) are the most common cause of infectious diarrhea in healthcare settings. CDI is always considered in patients receiving antimicrobials, who develop new-onset or worsening diarrhea. Although a two-step algorithm of stool tests using a glutamate dehydrogenase immunoassay and toxin enzyme immunoassay are commonly used, diagnosing CDI is challenging because of the lack of a gold standard for diagnosis. Clinicians should understand that the diagnosis of CDI relies on a high index of clinical suspicion, including the presence of symptoms and predisposing factors, and laboratory confirmation of C. difficile toxin in the stool. A recent guideline published by the Infectious Diseases Society of America reviews comprehensive treatment strategies including the choice of antimicrobials for CDI treatment, the indication for fecal microbiota transplantation in recurrent/relapsing CDI, and the role of surgical therapy in patients with severe CDI.

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