Anaerobic spore forming Gram positive bacilli, box-car shaped
Nosocomial > community onset diarrhea usually after taking antibiotics.
Can occur in outbreaks.
Recurrence is very common therefore previous history of C. difficile is a risk factor. Antacids, especially proton-pump inhibitors, and chemotherapy also increase risk.
Wide range of symptoms possible, and 15% are asymptomatic
Profuse, watery diarrhea
Pseudomembranous colitis or toxic megacolon
Normal colonizer in infants
Discontinue concomitant antibiotics whenever possible.
In refractory cases, stool transplants have been effective.
The lab will only accept liquid (diarrhea) stools, and only once per week.
Do not test patients receiving concomitant laxatives.
Hospitalized patients must remain in contact/spore precautions for the duration of their hospitalization, even if they change rooms.