Recent experience with influenza, the severe acute respiratorysyndrome (also known as SARS), avian influenza, and community-acquiredmethicillin-resistant Staphylococcus aureus has demonstratedhow old pathogens can emerge with increased virulence and challengescientists to explain their rebirth, clinicians to care forpatients, and infection-control personnel to prevent their spread.Clostridium difficile appears to illustrate these challenges.It already has some distinctive features: it causes diseasealmost exclusively in the presence of exposure to antibiotics,it is the only anaerobe that poses a nosocomial risk, and itproduces toxin in vivo only in the colon.
From the Department of Medicine, Johns Hopkins University School of Medicine, Baltimore.
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