Clostridia Difficile Diarrhea

Clostridia difficile is a gram positive, spore forming anaerobic bacilli1 Infection occurs when the organism is ingested. Though initially thought of as a nosocomial infection, community acquired clostridia difficile infection is increasingly recognized.2 Clostridia Difficile produces a variety of toxins, toxin A (enterotoxin) and B (cytotoxin) are the toxins most frequently linked to disease. They cause inflammation and disrupt cell cytoskeleton synthesis leading to colonic cell disruption.3,4,5 A new strain, termed NAP1 or BI or 027 (depending on the technique used to identify it) was identified in the early 2000s the cause of selected outbreaks. This strain of clostridia difficile is associated with clinically more severe disease, innate resistance to quinolones and higher amounts of toxin production.6