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REVIEW PAPER
Clostridioides difficile infection in adults – review of current knowledge (2020–2025)
1
Military Clinical Hospital No. 1 with Policlinic, Independent Public Health Care Unit, Lublin, Poland
These authors had equal contribution to this work
Corresponding author
ANNA SOSNOWSKA
1. Wojskowy Szpital Kliniczny Z Polikliniką SP ZOZ w Lublinie, 1. Wojskowy Szpital Kliniczny Z Polikliniką SP ZOZ w Lublinie, AL. RACŁAWICKIE 23, 20-049, LUBLIN, Poland
1. Wojskowy Szpital Kliniczny Z Polikliniką SP ZOZ w Lublinie, 1. Wojskowy Szpital Kliniczny Z Polikliniką SP ZOZ w Lublinie, AL. RACŁAWICKIE 23, 20-049, LUBLIN, Poland
KEYWORDS
diagnosticsmRNA vaccinesfecal microbiota transplantation (FMT)Clostridioides difficileridinilazolebezlotoxumab
TOPICS
ABSTRACT
Introduction and objective:
Clostridioides difficile infection (CDI) remains one of the leading causes of antibiotic-associated diarrhea and healthcare-associated infectious diarrhea in adults. The clinical spectrum ranges from mild diarrhea to fulminant colitis, toxic megacolon, sepsis, and death. In recent years, substantial progress has been made in understanding the epidemiology, pathogenesis, diagnostics, treatment, and prevention of recurrent CDI.
Review methods:
This study was prepared as a narrative literature review. The literature search included publications from 2020–2025 available in PubMed, Scopus, Web of Science, and Google Scholar. The search strategy was based on the following key words: Clostridioides difficile, Clostridioides difficile infection, CDI, epidemiology, diagnostics, treatment, recurrence, fidaxomicin, bezlotoxumab, fecal/faecal microbiota transplantation, microbiota restoration therapy, prevention, and probiotics.
Brief description of the state of knowledge:
The number of community-associated cases among Clostridioides difficile infections is increasing, which is related to its natural reservoirs. Diagnostic methods consist in multistage algorithms (GDH + toxin + NAAT). Fidaxomicin and vancomycin offer effective treatment, while bezlotoxumab and FMT, including standardized microbiota products, prevent CDI recurrence. Promising new therapies are emerging, such as ridinilazole, toxoid vaccine, mRNA vaccine, and microbial interventions.
Summary:
CDI remains a serious clinical problem in adult patients and continues to require improvement in diagnostics, treatment, and prevention. Further well-designed clinical trials and real-world studies are needed to optimize recurrence prevention strategies and improve long-term treatment outcomes in adult patients with CDI.
Clostridioides difficile infection (CDI) remains one of the leading causes of antibiotic-associated diarrhea and healthcare-associated infectious diarrhea in adults. The clinical spectrum ranges from mild diarrhea to fulminant colitis, toxic megacolon, sepsis, and death. In recent years, substantial progress has been made in understanding the epidemiology, pathogenesis, diagnostics, treatment, and prevention of recurrent CDI.
Review methods:
This study was prepared as a narrative literature review. The literature search included publications from 2020–2025 available in PubMed, Scopus, Web of Science, and Google Scholar. The search strategy was based on the following key words: Clostridioides difficile, Clostridioides difficile infection, CDI, epidemiology, diagnostics, treatment, recurrence, fidaxomicin, bezlotoxumab, fecal/faecal microbiota transplantation, microbiota restoration therapy, prevention, and probiotics.
Brief description of the state of knowledge:
The number of community-associated cases among Clostridioides difficile infections is increasing, which is related to its natural reservoirs. Diagnostic methods consist in multistage algorithms (GDH + toxin + NAAT). Fidaxomicin and vancomycin offer effective treatment, while bezlotoxumab and FMT, including standardized microbiota products, prevent CDI recurrence. Promising new therapies are emerging, such as ridinilazole, toxoid vaccine, mRNA vaccine, and microbial interventions.
Summary:
CDI remains a serious clinical problem in adult patients and continues to require improvement in diagnostics, treatment, and prevention. Further well-designed clinical trials and real-world studies are needed to optimize recurrence prevention strategies and improve long-term treatment outcomes in adult patients with CDI.
ABBREVIATIONS
CDI – Clostridioides difficile infection; ELISA – enzyme-linked immunosorbent assay; ESCMID – European Society of Clinical Microbiology and Infectious Diseases; FMT – fecal microbiota transplantation; GDH – glutamate dehydrogenase; IDSA – Infectious Diseases Society of America; NAAT – nucleic acid amplification tests; NPOA – National Programme for the Protection of Antibiotics; SHEA – Society for Healthcare Epidemiology of America
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| ISSN: | 1232-1966 |
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