Clostridium difficile: An Important Opportunistic Pathogen in Healthcare-Associated Infections
A close up photo of gloved hands holding a petri dish of C. diff culture
view on EDIS


Infectious Diseases
Clostridium difficile

How to Cite

Ahn, Soohyoun, and Amarat Simonne. 2018. “Clostridium Difficile: An Important Opportunistic Pathogen in Healthcare-Associated Infections: FSHN14-07/FS253, Rev. 1/2018”. EDIS 2018 (1). Gainesville, FL.


Healthcare-associated infections are infections that patients can get while receiving medical treatment in a healthcare facility. One opportunistic pathogen, Clostridium difficile, has been getting more attention in recent years because of its association with antibiotic use and a high death rate among the elderly. This 7-page factsheet will provide an overview of Clostridium difficile infection (CDI) with a focus on healthcare-associated infections. Written by Soohyoun Ahn and Amarat H. Simonne and published by the UF/IFAS Department of Food Science and Human Nutrition, January 2018.
view on EDIS


Banas, J. A. 2004. "Virulence properties of Streptococcus mutans." Front Biosci 9:1267-1277.

Bassetti, M., G. Villa, and D. Pecori. 2014. "Antibiotic-resistant Pseudomonas aeruginosa: focus on care in patients receiving assited ventilation." Future Microbiol 9:465-474.

Centers for Disease Control and Prevention (CDC). 2014. "Diseases and organisms in healthcare settings." Last accessed on November 6, 2017.

Centers for Disease Control and Prevention (CDC). 2015. "Clostridium difficile infection information for patients." Last accessed on November 30, 2017.

Centers for Disease Control and Prevention (CDC). 2016a. "HAI data and statistics." Last accessed on November 3, 2017.

Centers for Disease Control and Prevention (CDC). 2016b. "Clostridium difficile infection (CDI) - Prevention primer." Last accessed on November 14, 2017.

Chroneou, A., N. Zias, J. F. Beamis, Jr, and D. E. Craven. 2007. "Healthcare-associated pneumonia: principles and emerging concepts on management." Expert Opin Pharmacother. 8:3117-3131.

Danziger-Isakov, L. 2014. "Gastrointestinal infections after transplantation." Curr Opin Gastroenterol 30:40-46.

Dubberke, E. R., and D. N. Gerding. 2011. "Rationale for hand hygiene recommendations after caring for a patient with Clostridium difficile infection." Last accessed on November 30, 2017.

Hookman, P., and J. S. Barkin. 2009. "Clostridium difficile associated infection, diarrhea and colitis." World J. Gastroenterol. 15:1554-1580.

Kelly, C. P., and J. T. Lamont. 2014. "Clostridium difficile in adults: treatment." Last accessed on November 30, 2017.

Kerr, K. G. and A. M. Snelling. 2009. "Pseudomonas aeruginosa: a formidable and ever-present adversary." J. Hosp. Infect. 73:338-344.

Klevens, R. M., J. R. Edwards, C. L. Richards, Jr., T. C. Horan, R. P. Gaynes, D. A. Pollock, and D. M. Cardo. 2002. "Estimating health care-associated infections and deaths in US hospitals. Public Health Rep. 122:160-166.

Knoop, F. C., M. Owens, and I. C. Crocker. 1993. "Clostridium difficile: clinical disease and diagnosis." Clin. Microbiol. Rev. 6:251-265.

Kochanek, K. D., S. L. Murphy, J. Xu, and B. Tejada-Vera. 2016. "Deaths: final data for 2014." Natl Vital Stat Rep 65:1-122. Last accessed on November 30, 2017.

Kuehn, B. M. 2011. "Scientists seek strategies to prevent Clostridium difficile infections." JAMA 306:1849-1850.

Kyi, C., M. D. Hellmann, J. D. Wolchok, P. B. Chapman, and M. A. Postow. 2014. "Opportunistic infections in patients treated with immunotherapy for cancer." J. Immunother Cancer. 2:19.

Leffler, D. A. and J. T. Lamont. 2015. "Clostridium difficile infection." N. Engl. J. Med. 372:1539-1548.

Lessa, F. C., L. G. Winston, L. C. McDonald, and Emerging Infections Program C. difficile Surveillance Team. 2015. "Burden of Clostridium difficile infection in the United States." N. Engl. J. Med. 372:2369-2370.

Loo, V. G., P. Brassard, and M. A. Miller. 2016. "Household transmission of Clostridium difficile to family members and domestic pets." Infect. Control Hosp. Epidemiol. 37:1342-1348.

Magill, S. S., J. R. Edwards, W. Bamberg, Z. G. Beldavs, G. Dumyati, M. A. Kainer, R. Lynfield, R. et al. 2014. "Multistate point-prevalence survey of health care-associated infections." N. Engl. J. Med. 370:1198-1208.

Napolitano, L. M. and C. E. Edmiston Jr. 2017. "Clostridium difficile disease: Diagnosis, pathogenesis, and treatment update." Surgery 162:325-348.

Norén, T. 2010. "Clostridium difficile and the disease it causes." Methods Mol. Biol. 646:9-35.

Pagano, L., and M. Caira. 2012. "Risks for infection in patients with myelodysplasia and acute leukemia." Currn Opin Infect Dis. 25:612-618.

Pépin, J., L. Valiquette, and B. Cossette. 2005. "Mortality attributable to nosocomial Clostridium difficile-associated disease during an epidemic caused by a hypervirulent strain in Quebec." CMAJ. 173:1037-1042.

Rohlke, F. and N. Stollman. 2012. "Fecal microbiota transplantation in relapsing Clostridium difficile infection." Therap. Adv. Gastroenterol. 5:403-420.

Scott, R. D. II. 2009. "The direct medical costs of healthcare-associated infections in US hospitals and the benefits of prevention." Last accessed on November 6, 2017.

Sehulster, L., and R. Y. W. Chinn. 2003. "Guidelines for environmental infection control in health-care facilities: recommendations of CDC and the Healthcare Infection Control Practices Advisory Committee (HICPAC)." MMWR 52:1-42.

Siegel, J. D., E. Rhinehart, M. Jackson, L. Chiarello, and the Healthcare Infection Control Practices Advisory Committee. 2007. "2007 Guideline for isolation precautions: preventing transmission of infectious agents in healthcare settings." Last accessed on November 30, 2017.

Squellati, R. 2017. "Evidence-based practice in the treatment for antibiotic-associated diarrhea in the intensive care unit." Crit. Care Nurs. Clin. North Am.

Steiner, C., M. Barrett, and Y. Sun. 2015. "HCUP Projections: Clostridium Difficile Hospitalizations 2004-2015. 2015. HCUP Projections Report #2015-02." Last accessed on Nov 15, 2017.

Stone, N. E., L. C. Sidak-Loftis, J. W. Sahl, A. J. Vazquez, K. B. Wiggins, J. D. Gillece et al. 2016. "More than 50% of Clostridium difficile isolates from pet dogs in Flagstaff, USA, carry toxigenic genotypes." PLOS One 11:e0164504.

Teter, J, Florida Department of Health, Division of Disease Control and Health Protection. 2015. "Clostridium difficile diagnoses during hospitalizations, Florida, 2008-2013." Last accessed on November 28, 2017.

Tredget, E. E., H. A. Shankowsky, R. Rennie, R. E. Burrell, and S. Logsetty. 2004. "Pseudomonas infections in the thermally injured patient." Burns 30:3-26.

This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivs 4.0 International (CC BY-NC-ND 4.0) license.