Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2013 Aug 1;9(4):403-414.
doi: 10.2217/ahe.13.37.

Clostridium difficile infection in older adults

Robin Lp Jump  1
Affiliations

Clostridium difficile infection in older adults

Robin Lp Jump. Aging health. .

Abstract

Clostridium difficile infection, the most frequent cause of nosocomial diarrhea, disproportionately affects older adults. The two most important risk factors for developing C. difficile infection are antimicrobial exposure and age >65 years old. Risk factors specific to older adults are frequent interactions with healthcare systems and age-related changes in physiology, including immune senescence and changes to the gut microbiome. Metronidazole and oral vancomcyin are the mainstays of conventional treatment for C. difficile infection. Alternative therapies include fidaxomicin, a narrow-spectrum macrocyclic antibiotic, and fectal bacteriotherapy, which offers an excellent therapeutic outcome. Strategies to prevent C. difficile infections include enhanced infection control measures and reducing inappropriate antimicrobial use through stewardship.

Keywords: Clostridium difficile infection; aging; antimicrobial stewardship; fecal bacteriotherapy; fidaxomicin; infection control; long-term care facilities; metronidzole; older adults; vancomycin.

PubMed Disclaimer

Figures

Figure 1
Figure 1. The risk of hospitalization associated with a Clostridium difficile infection increases with age
Data taken from [19].
Figure 2
Figure 2. Percentage of Clostridium difficile infection cases by inpatient or outpatient status at the time of stool collection and type/location of exposures
Data taken from [20].
Figure 3
Figure 3. Following a Clostridium difficile infection-related hospital stay, the risk of readmission at 30 and 90 days due to C. difficile infection increases with age
Data taken from [62].
See this image and copyright information in PMC

References

    1. Lawley TD, Walker AW. Intestinal colonization resistance. Immunology. 2013;138:1–11. - PMC - PubMed
    1. Kuehne SA, Cartman ST, Minton NP. Both, toxin A and toxin B, are important in Clostridium difficile infection. Gut Microbes. 2011;2:252–255. - PMC - PubMed
    1. al-Barrak A, Embil J, Dyck B, et al. An outbreak of toxin A negative, toxin B positive Clostridium difficile-associated diarrhea in a Canadian tertiary-care hospital. Can Commun Dis Rep. 1999;25:65–69. - PubMed
    1. Lyras D, O’Connor JR, Howarth PM, et al. Toxin B is essential for virulence of Clostridium difficile. Nature. 2009;458:1176–1179. - PMC - PubMed
    1. Kuehne SA, Cartman ST, Heap JT, Kelly ML, Cockayne A, Minton NP. The role of toxin A and toxin B in Clostridium difficile infection. Nature. 2010;467:711–713. - PubMed

Websites

    1. US Department of Health and Human Services. [Accessed 4 March 2013];National targets and metrics. www.hhs.gov/ash/initiatives/hai/nationaltargets/index.html.
    1. Murphy SL, Xu J, Kochanek KD. National vital statistic reports. [Accessed 1 April 2013];Deaths: preliminary data for 2010. 2012 www.cdc.gov/nchs/data/nvsr/nvsr60/nvsr60_04.pdf. - PubMed

LinkOut - more resources