Clostridium difficile is an increasingly important problem being faced by clinical microbiologists. From 1993 to 2009, incidence of C. difficile increased fourfold (85,700 cases increased to 336,600 cases) in the United States. Because of this, it has become a significant area of research, as researchers search for better antimicrobial therapies, diagnostic assays, and prevention tactics. ASM recently invited Alice Guh, MD, MPH, of the Centers for Disease Control and Prevention, to present the most recent C. difficile research as part of the Hot Topics in Clinical Microbiology series*. In her presentation, ‘Update on Clostridium difficile Infection’, Guh first describes the changing epidemiology of C. difficile infections (CDI), updating the data from the CDC’s Emerging Infections Program (EIP) and their long-term surveillance of CDI within the United States.
Guh further reviews current CDI diagnostic testing and its associated challenges. She highlights the benefits and downfalls of traditional enzyme immunoassay to detect C. difficile toxins compared to the nucleic acid amplification tests (NAAT) first put to widespread use in 2009.
Finally, Guh describes the role of asymptomatic carriers in C. difficile transmission. Her review of the literature presents best practices to trace transmission from asymptomatic carriers as well as suggested strategies to stop this transmission.
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