Purpose of review: Clostridium difficile infection (CDI), long-associated with morbidity and mortality in healthcare settings, has evolved in recent years with unprecedented clinical manifestations. Today, CDI is characterized by unusually toxigenic and resistant subtypes, expanded epidemiology, and a growing list of risk factors. In this article, we discuss current trends and research for CDI in critical care settings, and new controversies that influence clinical practice.
Recent findings: CDI is the focus of intense and comprehensive research. For the critical care practitioner, relevant knowledge includes diagnosis of CDI, defining the severity of disease, the role of proton pump inhibitors, and treatment options for refractory or relapsing disease.
Summary: Annually, CDI adds billions of dollars to US healthcare costs compared with just a few years ago, and reflects a new and profound pattern of morbidity and mortality. As this disease changes, our knowledge and practice patterns must adjust to meet the current challenge of CDI.