From the hospital to the home--the rise and rise of Clostridium difficile infection.

ABSTRACT

BACKGROUND: Clostridium difficile infection (CDI) has emerged as a serious worldwide public health threat. Although C. difficile has always been a cause of diarrhoeal disease in patients presenting to general practice, the rates of community-associated CDI (CA CDI) have increased. OBJECTIVE: This article provides a summary of what is currently known about CA CDI and the implications for Australian general practitioners (GPs). DISCUSSION: Changes in the colonic flora (most often because of antibiotic use) and exposure to C. difficile are both required for the disease to develop. Potential sources of C. difficile in the community include the home environment, food and water, workplace and environment. Identification of risk factors for CDI may help in the early diagnosis and subsequent management of infection, and these are being explored further. GPs have a role in understanding and managing CA CDI through prudent prescribing, patient education and adequate testing.