Louie, Thomas J2018-09-272018-09-272006-01-01Thomas J Louie, “Clostridium difficile in Clinical Practice: Increasing Rates, More Virulent Organisms and New Therapies on the Horizon,” Canadian Journal of Infectious Diseases and Medical Microbiology, vol. 17, no. Suppl B, pp. 19B-24B, 2006. doi:10.1155/2006/378702http://hdl.handle.net/1880/108544https://doi.org/10.11575/PRISM/44322Clostridium difficile-associated diarrhea has recently come underincreasing scrutiny because of outbreaks of disease in eastern Canadain association with a hypervirulent ribotype 027 (NAP1) strain.Hospitals in the United States, the United Kingdom and Europe havebeen affected as well. Epidemiological studies are underway to determinethe presence of the more virulent strain of C difficile in hospitalsacross Canada. Because this strain is highly quinolone resistant, it issuspected that overuse of that class of antimicrobial agent may be aselection factor for this strain. Although C difficile-associated diarrheais usually considered a nosocomial infection, approximately one-quarterof cases occur in the community. Recurrence following successful resolutionof diarrhea occurs in one in five patients treated with metronidazoleor vancomycin; relapse is more common in patients needingretreatment. New therapies that may have equivalent or higherresponse rates and lower recurrence rates are being investigated. It ishoped that these new treatments will be a substantial improvementover current therapies. In the interim, prudent antimicrobial use andattention to infection control practices are the main preventivestrategies. Prompt testing for C difficile toxin in patients with diarrheaafter antibiotic exposure, discontinuation of unnecessary antibiotictherapy and rapid initiation of treatment should minimize complications.With the appearance of more toxigenic strains of C difficile,careful monitoring of patients to detect suboptimal clinical response isnecessary.Journal Article2018-09-27enCopyright © 2006 Hindawi Publishing Corporation. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.https://doi.org/10.1155/2006/378702