Clostridioides difficile–Associated Diarrhea: Infection Prevention Unknowns and Evolving Risk Reduction Strategies

  • Michelle DollEmail author
  • Michele Fleming
  • Michael P. Stevens
  • Gonzalo Bearman
Healthcare Associated Infections (G. Bearman and D. Morgan, Section Editors)
Part of the following topical collections:
  1. Topical Collection on Healthcare Associated Infections


Purpose of Review

New controversies in the diagnosis and prevention of Clostridiodes difficile are challenging and at times changing infection control practice at many medical centers.

Recent Findings

Molecular epidemiologic studies are changing our understanding of C. difficile and its spectrum of disease. C. difficile as a hospital-acquired infection is likely largely overdiagnosed given overly sensitive molecular testing and widespread colonization of ill or debilitated patients.


Clostridiodes difficile infection continues to challenge infection prevention programs. Shifts in our understanding of the epidemiology of this organism and its spectrum of clinical presentations are changing the approach to prevention efforts. Nevertheless, cleanliness of the healthcare environment and antimicrobial stewardship remain core risk reduction strategies. Other strategies such as screening and isolation are inciting controversy. The optimal infection prevention strategies for C. difficile remain the subject of intense study and debate.


Clostridiodes difficile C. difficile Antibiotic stewardship Diagnostic stewardship Infection prevention 


Compliance with Ethical Standards

Conflict of Interest

Kaila Cooper and Michael Stevens declare that they have no conflict of interest.

Michelle Doll and Gonzalo Bearman have received grants from Molnlycke Healthcare.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance •• Of major importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2019

Authors and Affiliations

  • Michelle Doll
    • 1
    Email author
  • Michele Fleming
    • 1
  • Michael P. Stevens
    • 1
  • Gonzalo Bearman
    • 1
  1. 1.Virginia Commonwealth University Medical CenterRichmondUSA

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