Jornal de Doenças Infecciosas e Tratamento Acesso livre

Abstrato

Clostridium difficile: Current Status and Treatment Perspectives

Beatriz Suay García and María Teresa Pérez?Gracia

Clostridium difficile is considered one of the most important pathogens in both, hospital and community settings. This pathogen is responsible for most antibioticassociated colitis in hospitals and a major cause of morbidity and mortality within the elderly. Clostridium difficile infection (CDI) usually appears as a result of antibiotic therapy, which disrupts the normal gut flora. Clostridium difficile infection presents itself in two very distinct ways, it can be either asymptomatic, with the infected person acting as a carrier, or symptomatic, where patients may experience a broad range of symptoms depending on their severity. Symptoms range from mild diarrhea to severe complications such as pseudomembranous colitis, toxic megacolon, bowel perforation, sepsis and death. Conventional treatment of CDI consists on antibiotic treatment with vancomycin or metronidazole. However, the number of recurrences after using these treatments is growing exponentially. New molecules such as fidamoxicin have been included in treatment guidelines but still; the cases of recurrent CDI continue to grow. As a result, a novel therapy has emerged: fecal microbiota transplants (FMT). It is a procedure in which fecal matter, or stool, is collected from a tested donor, mixed with a saline or other solution, strained, and placed in a patient by colonoscopy, endoscopy, sigmoidscopy or enema. With its efficacy being proven constantly study after study, it is only a matter of time for health organizations worldwide to include it in the guidelines for rCDI treatment.