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Clostridioides%20difficile%20infection Signs and Symptoms
Introduction
- Clostridioides (formerly Clostridium) difficile infection is commonly associated with antibiotic treatment and is one of the most common nosocomial infections
Signs and Symptoms
- Symptoms usually start on days 2-3 of antibiotic treatment, but may also occur up to 8-12 weeks after discontinuation of antibiotics
- Acute diarrhea in an inpatient of ≥3 loose stools in ≤24 hours and in an outpatient of ≥3 loose stools in 24 hours for at least 2 consecutive days or ≥8 loose stools in 48 hours
- Worsening of chronic diarrhea
- Increasing output from an ostomy site after a recent antibiotic use
- Severe pain and abdominal distension after an episode of diarrhea with no current stool output may indicate ileus or toxic megacolon
Risk Factors
- Antibiotic therapy
- Antibiotics most commonly implicated are the cephalosporins, monobactams, carbapenems, fluoroquinolones, beta-lactamase inhibitor combinations and Clindamycin
- Macrolides, aminoglycosides, sulfonamides and other penicillins are less commonly involved
- Prolonged antibiotic administration increases the risk of C difficile colitis, but even a brief exposure to a single antibiotic may cause disease
- Intensive care unit (ICU) admission
- Prolonged stay in the hospital
- Sharing a hospital room with a C difficile-infected patient
- Recent surgery
- Advanced age
- Residing in a nursing home or long-term care facility
- Severe comorbid illnesses
- Immunosuppressive therapy
- Use of a nasogastric tube
- Use of antacids
