Special Issue "Clostridium difficile Infection: Unmet Needs and Unsolved Questions"
Deadline for manuscript submissions: 31 May 2021.
Interests: healthcare associated infections; multidrug resistant organisms; antimicrobial stewardship; infection prevention and control; emerging infectious diseases; Clostridioides difficile infection
The current picture of Clostridioides difficile infection (CDI) is alarming with a recurrence rate ranging from 12% to 40% and a not negligible mortality rate, i.e., between 3% and 15%. Despite the great efforts made over the past 10 years to face the CDI burden, there are still grey areas in our knowledge on CDI management.
Major issues affecting the management of CDI include the high rate of CDI underdiagnosis, the unacceptably high rate of CDI recurrence, and the difficulties faced in reducing the spread of CD among hospitalized patients.
The underdiagnosis of CDI is a recognized issue, either because of suboptimal laboratory diagnostic methods or because of absence of clinical suspicion. There are unsolved questions, such as why the rate of underdiagnosis differs among countries and among hospitals in the same countries, and there is a need to elucidate the reasons for its high rate. In this regard, community-acquired CDI are increasingly represented in the literature, but in “real life”, they are poorly studied, and their underdiagnosis has been hypothesized.
A further critical issue in the management of CD regards the high recurrence rate observed with the currently available CDI therapy. Importantly, in the last few years, many advances in the field of pathogenesis of CDI and on the role of intestinal microbiota have been made, and new strategies for the treatment and prevention of CDI are being studied.
Undeniably, more efforts are needed in order to reduce the spread of CDI, especially among hospitalized patients. Asymptomatic CD carriers might represent a “submerged iceberg” that significantly contributes to the CD hospital spread. Understanding the role asymptomatic carriers play in perpetuating CD transmission in healthcare settings as well as defining the usefulness of contact isolation for them is crucial but also particularly challenging to examine.
Dr. Nicola Petrosillo
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