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Previous Volume 359:1932-1940 October 30, 2008 Number 18 Next

	Since this article has no abstract, we have provided an extract of the first 100 words of the full text and any section headings.

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In 1935, Hall and O'Toole first isolated a gram-positive, cytotoxin-producing anaerobic bacterium from the stool of healthy neonates.¹ They named it Bacillus difficilis to reflect the difficulties they encountered in its isolation and culture. We now face the opposite problem of being unable to contain the growth and spread of the same bacterium, now called Clostridium difficile, which is a frequent cause of infectious colitis, usually occurring as a complication of antibiotic therapy, in elderly hospitalized patients. In this article we review recent changes in the epidemiology of C. difficile infection, discuss changes in disease severity and response to therapy, . . . [Full Text of this Article]

Incidence and Severity

Emergence of a Virulent Strain

Expanding Epidemiology

Metronidazole versus Vancomycin

Recurrent Infection

Role of Host Immunity

Management of Recurrence

            General Considerations

            Antibiotics and Probiotics

            Immunotherapy

            Bacteriotherapy

            New Antibiotics

Summary

Source Information

From the Gastroenterology Division, Department of Medicine, Beth Israel Deaconess Medical Center and Harvard Medical School, Boston.

Address reprint requests to Dr. Kelly at Dana 601, Gastroenterology BIDMC, 330 Brookline Ave., Boston, MA 02215.

Related Letters:

Clostridium difficile
Pollok R. C.G., Baierlein S. A., Wistop A., Della-Torre E., Dagna L., Saporiti N., Coulter D. M., Kelly C. P., LaMont J. T.
Extract | Full Text | PDF  
N Engl J Med 2009; 360:636-638, Feb 5, 2009. Correspondence

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