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. 2023 Mar 26;11(4):845.
doi: 10.3390/microorganisms11040845.

Clostridioides difficile, a New "Superbug"

Rumyana Markovska  1 , Georgi Dimitrov  1 , Raina Gergova  1 , Lyudmila Boyanova  1
Affiliations

Clostridioides difficile, a New "Superbug"

Rumyana Markovska et al. Microorganisms. .

Abstract

Clostridioides difficile is a Gram-positive, spore-forming, anaerobic bacterium. The clinical features of C. difficile infections (CDIs) can vary, ranging from the asymptomatic carriage and mild self-limiting diarrhoea to severe and sometimes fatal pseudomembranous colitis. C. difficile infections (CDIs) are associated with disruption of the gut microbiota caused by antimicrobial agents. The infections are predominantly hospital-acquired, but in the last decades, the CDI patterns have changed. Their prevalence increased, and the proportion of community-acquired CDIs has also increased. This can be associated with the appearance of hypervirulent epidemic isolates of ribotype 027. The COVID-19 pandemic and the associated antibiotic overuse could additionally change the patterns of infections. Treatment of CDIs is a challenge, with only three appropriate antibiotics for use. The wide distribution of C. difficile spores in hospital environments, chronic persistence in some individuals, especially children, and the recent detection of C. difficile in domestic pets can furthermore worsen the situation. "Superbugs" are microorganisms that are both highly virulent and resistant to antibiotics. The aim of this review article is to characterise C. difficile as a new member of the "superbug" family. Due to its worldwide spread, the lack of many treatment options and the high rates of both recurrence and mortality, C. difficile has emerged as a major concern for the healthcare system.

Keywords: Clostridium difficile; epidemiology; mortality; superbug; virulence.

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Conflict of interest statement

The authors declare there is no conflict of interest.

Figures

Figure 1
Figure 1
Main characteristics of Clostridioides difficile infections [9,10,17]. Abbreviations: EIA—enzyme immunoassay; GDH—glutamate dehydrogenase.
Figure 2
Figure 2
Distribution of some important C. difficile ribotypes in different continents [17,57,58,59,60,61,62,63,64,65,66].
See this image and copyright information in PMC

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