Nephrol Dial Transplant (2000) 15: 571-574
© 2000 European Renal Association-European Dialysis and Transplant Association
Editorial Comments
Clostridium difficile in patients with renal failure — management of an outbreak using biotherapy
Department of Nephrology, Leicester General Hospital, and 1 Clinical Microbiology and Public Health Laboratory, Leicester, UK
Keywords: Clostridium difficile; Saccharomyces boulardi
Introduction
Clostridium difficile is a Gram-positive, spore-forming, toxin-producing, obligate anaerobe that is ubiquitous in nature. Over the past decade, it has become a very prominent nosocomial infection worldwide. It is notable that C. difficile infection caused ward closures in 5% of UK hospitals in 1993, and by 1996 this figure had risen to 16% [1]. However, the available epidemiological data may not be accurate. Diagnosis depends on stool culture and testing for toxin, but wide variation in practices for stool collection and in laboratory methods for diagnosis make it difficult to know the true incidence.
It was first recognized as a potential pathogen in 1935 when it was described as ‘Bacillus difficile’ [2]. However, its identification as a normal bowel commensal and subsequent association with pseudo-membranous colitis in relation to broad spectrum antibiotics was only established in the late 1970s [3,4].
Clinical presentation
Diagnosis
Current recommendations for treatment
The role of yeast (S. boulardii)
Management of a cohort of patients
Conclusion
Acknowledgments
Notes
References