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Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications

BACKGROUND: The epidemiology of Clostridium difficile infection (CDI) has changed over the past decades with the emergence of highly virulent strains. The role of asymptomatic C. difficile colonization as part of the clinical spectrum of CDI is complex because many risk factors are common to both di...

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Autores principales: Furuya-Kanamori, Luis, Marquess, John, Yakob, Laith, Riley, Thomas V., Paterson, David L., Foster, Niki F., Huber, Charlotte A., Clements, Archie C. A.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: BioMed Central 2015
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647607/
https://www.ncbi.nlm.nih.gov/pubmed/26573915
http://dx.doi.org/10.1186/s12879-015-1258-4
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author Furuya-Kanamori, Luis
Marquess, John
Yakob, Laith
Riley, Thomas V.
Paterson, David L.
Foster, Niki F.
Huber, Charlotte A.
Clements, Archie C. A.
author_facet Furuya-Kanamori, Luis
Marquess, John
Yakob, Laith
Riley, Thomas V.
Paterson, David L.
Foster, Niki F.
Huber, Charlotte A.
Clements, Archie C. A.
author_sort Furuya-Kanamori, Luis
collection PubMed
description BACKGROUND: The epidemiology of Clostridium difficile infection (CDI) has changed over the past decades with the emergence of highly virulent strains. The role of asymptomatic C. difficile colonization as part of the clinical spectrum of CDI is complex because many risk factors are common to both disease and asymptomatic states. In this article, we review the role of asymptomatic C. difficile colonization in the progression to symptomatic CDI, describe the epidemiology of asymptomatic C. difficile colonization, assess the effectiveness of screening and intensive infection control practices for patients at risk of asymptomatic C. difficile colonization, and discuss the implications for clinical practice. METHODS: A narrative review was performed in PubMed for articles published from January 1980 to February 2015 using search terms ‘Clostridium difficile’ and ‘colonization’ or ‘colonisation’ or ‘carriage’. RESULTS: There is no clear definition for asymptomatic CDI and the terms carriage and colonization are often used interchangeably. The prevalence of asymptomatic C. difficile colonization varies depending on a number of host, pathogen, and environmental factors; current estimates of asymptomatic colonization may be underestimated as stool culture is not practical in a clinical setting. CONCLUSIONS: Asymptomatic C. difficile colonization presents challenging concepts in the overall picture of this disease and its management. Individuals who are colonized by the organism may acquire protection from progression to disease, however they also have the potential to contribute to transmission in healthcare settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-015-1258-4) contains supplementary material, which is available to authorized users.
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spelling pubmed-46476072015-11-18 Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications Furuya-Kanamori, Luis Marquess, John Yakob, Laith Riley, Thomas V. Paterson, David L. Foster, Niki F. Huber, Charlotte A. Clements, Archie C. A. BMC Infect Dis Research Article BACKGROUND: The epidemiology of Clostridium difficile infection (CDI) has changed over the past decades with the emergence of highly virulent strains. The role of asymptomatic C. difficile colonization as part of the clinical spectrum of CDI is complex because many risk factors are common to both disease and asymptomatic states. In this article, we review the role of asymptomatic C. difficile colonization in the progression to symptomatic CDI, describe the epidemiology of asymptomatic C. difficile colonization, assess the effectiveness of screening and intensive infection control practices for patients at risk of asymptomatic C. difficile colonization, and discuss the implications for clinical practice. METHODS: A narrative review was performed in PubMed for articles published from January 1980 to February 2015 using search terms ‘Clostridium difficile’ and ‘colonization’ or ‘colonisation’ or ‘carriage’. RESULTS: There is no clear definition for asymptomatic CDI and the terms carriage and colonization are often used interchangeably. The prevalence of asymptomatic C. difficile colonization varies depending on a number of host, pathogen, and environmental factors; current estimates of asymptomatic colonization may be underestimated as stool culture is not practical in a clinical setting. CONCLUSIONS: Asymptomatic C. difficile colonization presents challenging concepts in the overall picture of this disease and its management. Individuals who are colonized by the organism may acquire protection from progression to disease, however they also have the potential to contribute to transmission in healthcare settings. ELECTRONIC SUPPLEMENTARY MATERIAL: The online version of this article (doi:10.1186/s12879-015-1258-4) contains supplementary material, which is available to authorized users. BioMed Central 2015-11-14 /pmc/articles/PMC4647607/ /pubmed/26573915 http://dx.doi.org/10.1186/s12879-015-1258-4 Text en © Furuya-Kanamori et al. 2015 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
spellingShingle Research Article
Furuya-Kanamori, Luis
Marquess, John
Yakob, Laith
Riley, Thomas V.
Paterson, David L.
Foster, Niki F.
Huber, Charlotte A.
Clements, Archie C. A.
Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications
title Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications
title_full Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications
title_fullStr Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications
title_full_unstemmed Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications
title_short Asymptomatic Clostridium difficile colonization: epidemiology and clinical implications
title_sort asymptomatic clostridium difficile colonization: epidemiology and clinical implications
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4647607/
https://www.ncbi.nlm.nih.gov/pubmed/26573915
http://dx.doi.org/10.1186/s12879-015-1258-4
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