Clostridium difficile: progress and challenges


Address for correspondence: John G. Bartlett, School of Medicine, Johns Hopkins University, 1830 East Monument Street, Rm 447, Baltimore, Maryland 21205.


There is a surge of new interest in C. difficile infection (CDI) reflecting substantial increases in cases and fatalities. The new challenges by this now old pathogen have brought renewed interest in all facets of the disease. Particularly important are the role of fluoroquinolones as inducing agents, the new polymerase chain reaction test to detect toxigenic strains in stools, the important role of the NAP-1 strain, recent evidence favoring oral vancomycin over metronidazole in seriously ill patients, and new guidelines for management.