CLOSTRIDIUM DIFFICILE: A GROWING HEALTH CONCERN

Abstract

Clostridium difficile is a potent nosocomial pathogen being one of the major causes of Antibiotic Associated Diarrhea. Excessive utilization of broad spectrum antibiotics destabilizes the gut microflora and compromises immunity thereby facilitating the growth and proliferation of this bacterium culminating in the disease. Infection is usually transmitted through transfer of spores via the fecal oral route. Toxin A and B are the predominant toxins responsible for the disease that disseminate intestinal barrier and initiate Rho GTPases activated Interleukin mediated inflammatory pathway. Improper sanitary conditions, contaminated food, animal manure and unclean medical setups are the primary sources of infection. This microorganism is generally diagnosed on taurocholate enrichment agar in combination with advanced techniques including Real Time PCR, enzyme immunoassays and restriction endonuclease analysis. Although Vancomycin and Metronidazole are the first lines of treatment, their efficacy has been found to be compromised mainly because of emergence of novel strains with increased virulence as well as resistance. New drugs including Fidaxomicin and Ribaxamase and advanced techniques like Fecal Microbiota Transplantation are now often used in combination with the former in order to curtail the above. Microbial replacement and utilization of outer membrane of the pathogen are recent breakthroughs towards containment of the disease. Since Clostridium difficile has now become one of the major health concerns, knowledge of pathogenesis, minimization of risk factor and development of alternative therapeutics may reduce the negative health consequences inferred by this infectious pathogen.