An Old Microbe

by Michael_Koger

Clostridioides difficile (CDI) is a well-known microorganism.

This is a microorganism which has occurred in the United States for a long time. There is a connection with recent usage of antimicrobial therapy as well. Scholarly journals have long noted that the increase in the types of these agents commonly occurs when there are patients who reside in long-term care facilities.

This distressing infection happens in the United States, and it affects a half million people each year. Some clients suffer more than others, and not everyone will have it. Hence, some will suffer from abdominal cramps, and others describe watery diarrhea which recurs many times a day. Moreover, this infirmity will lead to increase in the white blood cell count, kidney failure, nausea, and problems with appetite. It is obvious that these scenarios suffer from dehydration in many instances. Another serious concern is the presence of fast heart rate, fever, blood in the stool, and enlargement of the colon (1, 2, 3, 4, 5).

Seriousness of CDI

     Unfortunately, these patients will suffer from toxic megacolon, and they may have to spend time in an intensive care unit.  It is a recurrent illness in many patients who require close follow up.  In any event, there are several risk factors.  For example, it commonly affects elderly individuals in their sixties as they require serious monitoring.  Moreover, there are several infirmities which can worsen CDI.  These include human immunodeficiency virus, cancer, and organ transplant.  These observations may be present too as these clients are at risk for them as well (1, 2, 3, 4, 5).

     In general, the microorganism which leads to C. difficile has to do with spore exposure.  In the gastrointestinal tract, there are germination, colonization, and disease which may lead to Toxin A and Toxin B.  Also, one must consider community, food, water, and animals.  The management of infants is essential, and these special intensive care units require excellent work.  It is important to know that recovery and relapse are sometimes the result of primary acute illness (1, 2, 3).

     The importance of antimicrobials considers the change in these agents as well as other factors.  For example, metronidazole or vancomycin may become the result of these interactions.  Some of these illustrations may include economic burden, risk factors, and disease impact.  Epidemiology, therefore, demonstrates that these situations have taken place for a long time in history (1, 2, 3).

Older Methods in Medicine

     It would be reasonable to explore some well-known rules and regulations of health care.  For example, handwashing, isolation, and environmental decontamination have been part of medical care for decades and likely over centuries even in ways which have changed the field of health care.  People of all lines of thought are actively informing children about the importance of handwash, mouthwash, and isolation.  Moreover, the practice of vaccination varies over decades.  This is quite true as elderly individuals undergo variations in their health care.  At the same time, there is no restriction for any patient as medical conditions can appear anytime (1).

     From the literature, Dubberke describes interesting issues which the health care team will need whether recent or not.  For example, the writers describe $3.2 billion in the year 2008, and this obviously will affect clinical management.  Researchers also mention clindamycin, ampicillin, fluoroquinolone, and cephalosporins as problematic for some patients because of drug resistance.  There are also connections between Europe and the United States in terms of pseudomembranous colitis and use of procedures such as endoscopy, surgery, or histopathological examination (Cambridge University Press, page 583).


     Medicine continues to change as discovery and modern approaches enable patients and health care practitioners to become aware of these matters.


  1. World Health Organization.  (2016).  Clostridium difficile. Dr. Gill Douce.  University of Glasgow.
  2. Mayo Clinic.  (2021).  C. difficile infection.
  3. U.S. Centers for Disease Control.  (2021).  Clostridioides difficile.  
  4. Dubberke, E., Gerding, D., Classen, D. et al.  (2008).  Infection Control and Hospital Epidemiology, 29, S81-S92.  This work is also a Cambridge University Press on behalf of The Society for Healthcare Epidemiology of America.
  5. Tsigrelis, C.  (2020).  Recurrent Clostridioides difficile:  Recognition, management, and prevention.  Cleveland Clinic Journal of Medicine, 87, 347-359.
  6. Copyright 2021.  Michael Koger, Sr., M.D.  All rights reserved.


     The information contained in this article is for educational purposes only, and one should not use it for diagnosis or treatment without the opinion of a health professional. Any reader who is concerned about his or her health should contact their physician for advice.

Updated: 04/04/2021, Michael_Koger
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DerdriuMarriner on 04/01/2021

Michael Koger, Thank you for the practical information.
Online information indicates that Clostridioides difficile is present in soil. Is it possible that gardeners, lawn and plant care specialists and naturalists may be more vulnerable to exposure to the bacteria?
It may have been in 2019 that the United Nations released a report on worldwide degradation of soils from all the chemicals, especially fertilizers and pesticides, in soils and from such practices as clear-cutting. Would that make, or not make, it easier for the bacteria to thrive depending upon bacterial resistance?
Online information also pinpoints ciprofloxacin as problematic. It puzzles me that cipro has so taken over as an antibiotic for those not liking penicillin. Penicillin works wonders for those who handle it. Would there be that many people intolerant of penicillin to warrant the cipro takeover?

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