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  • Authors: Jae Hyun Shin1, Esteban Chaves-Olarte2, Cirle A. Warren3
  • Editors: W. Michael Scheld4, James M. Hughes5, Richard J. Whitley6
    Affiliations: 1: Department of Medicine, Division of Infectious Disease and International Health, University of Virginia, Charlottesville, VA 22908; 2: Centro de Investigación en Enfermedades Tropicales, Facultad de Microbiología, Universidad de Costa Rica, Costa Rica; 3: Department of Medicine, Division of Infectious Disease and International Health, University of Virginia, Charlottesville, VA 22908; 4: Department of Infectious Diseases, University of Virginia Health System, Charlottesville, VA; 5: Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine, Atlanta, GA; 6: Department of Pediatrics, University of Alabama at Birmingham, Birmingham, AL
  • Source: microbiolspec May 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0007-2015
  • Received 13 November 2015 Accepted 04 December 2015 Published 27 May 2016
  • Cirle A. Warren, [email protected]
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  • Abstract:

    is an anaerobic, Gram-positive, spore-forming, toxin-secreting bacillus that has long been recognized to be the most common etiologic pathogen of antibiotic-associated diarrhea. infection (CDI) is now the most common cause of health care–associated infections in the United States and accounts for 12% of these infections (Magill SS et al., 1198–1208, 2014). Among emerging pathogens of public health importance in the United States, CDI has the highest population-based incidence, estimated at 147 per 100,000 (Lessa FC et al., 825–834, 2015). In a report on antimicrobial resistance, has been categorized by the Centers for Disease Control and Prevention as one of three “urgent” threats (http://www.cdc.gov/drugresistance/threat-report-2013/). Although was first described in the late 1970s, the past decade has seen the emergence of hypertoxigenic strains that have caused increased morbidity and mortality worldwide. Pathogenic strains, host susceptibility, and other regional factors vary and may influence the clinical manifestation and approach to intervention. In this article, we describe the global epidemiology of CDI featuring the different strains in circulation outside of North America and Europe where strain NAP1/027/BI/III had originally gained prominence. The elderly population in health care settings has been disproportionately affected, but emergence of CDI in children and healthy young adults in community settings has, likewise, been reported. New approaches in management, including fecal microbiota transplantation, are discussed.

  • Citation: Shin J, Chaves-Olarte E, Warren C. 2016. Infection. Microbiol Spectrum 4(3):EI10-0007-2015. doi:10.1128/microbiolspec.EI10-0007-2015.


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is an anaerobic, Gram-positive, spore-forming, toxin-secreting bacillus that has long been recognized to be the most common etiologic pathogen of antibiotic-associated diarrhea. infection (CDI) is now the most common cause of health care–associated infections in the United States and accounts for 12% of these infections (Magill SS et al., 1198–1208, 2014). Among emerging pathogens of public health importance in the United States, CDI has the highest population-based incidence, estimated at 147 per 100,000 (Lessa FC et al., 825–834, 2015). In a report on antimicrobial resistance, has been categorized by the Centers for Disease Control and Prevention as one of three “urgent” threats (http://www.cdc.gov/drugresistance/threat-report-2013/). Although was first described in the late 1970s, the past decade has seen the emergence of hypertoxigenic strains that have caused increased morbidity and mortality worldwide. Pathogenic strains, host susceptibility, and other regional factors vary and may influence the clinical manifestation and approach to intervention. In this article, we describe the global epidemiology of CDI featuring the different strains in circulation outside of North America and Europe where strain NAP1/027/BI/III had originally gained prominence. The elderly population in health care settings has been disproportionately affected, but emergence of CDI in children and healthy young adults in community settings has, likewise, been reported. New approaches in management, including fecal microbiota transplantation, are discussed.

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Gross pathology of pseudomembranous colitis. Histopathology of pseudomembranous colitis.

Source: microbiolspec May 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0007-2015
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Risk factors associated with acquisition of

Source: microbiolspec May 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0007-2015
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Emerging trends in the management of infection

Source: microbiolspec May 2016 vol. 4 no. 3 doi:10.1128/microbiolspec.EI10-0007-2015

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