Clostridium difficile-associated diarrhoea

Intern Med J. 2007 Aug;37(8):561-8. doi: 10.1111/j.1445-5994.2007.01403.x.


Clostridium difficile is an important nosocomial pathogen and the most frequently diagnosed cause of infectious hospital-acquired diarrhoea. Toxigenic strains usually produce toxin A and toxin B, which are the primary virulence factors of C. difficile. Some recently described strains produce an additional toxin, an adenosine-diphosphate ribosyltransferase known as binary toxin, the role of which in pathogenicity is unknown. There has been concern about the emergence of a hypervirulent fluoroquinolone-resistant strain of C. difficile in North America and Europe. The use of fluoroquinolone antimicrobials appears to be acting as a selective pressure in the emergence of this strain. In this review, we describe the current state of knowledge about C. difficile as a cause of diarrhoeal illness.

Publication types

  • Review

MeSH terms

  • Clostridium Infections* / diagnosis
  • Clostridium Infections* / microbiology
  • Clostridium Infections* / prevention & control
  • Clostridium difficile* / drug effects
  • Cross Infection / diagnosis
  • Cross Infection / microbiology
  • Cross Infection / prevention & control
  • Diarrhea / microbiology*
  • Drug Resistance, Bacterial
  • Enterocolitis, Pseudomembranous / diagnosis
  • Enterocolitis, Pseudomembranous / drug therapy
  • Enterocolitis, Pseudomembranous / microbiology
  • Fluoroquinolones / pharmacology
  • Humans


  • Fluoroquinolones