Infection à Clostridium difficile : physiopathologie, diagnostic et traitement

Clostridium difficile is a gram positive bacillus which can be implicated in various clinical manifestations. It can be found in asymptomatic carrier-patients, but it can also lead to post-antibiotic diarrhoea as well as severe pseudomembranous colitis. C. difficile particularly affects elderly people and hospitalised patients, however the incidence of its community infection is probably underestimated nowadays. If antibiotic exposure facilitates the emergence of C. difficile, patient's immune status and host's ability to secrete anti-toxin A IgG determines its clinical expression. Preventive care stands on a reasonable use of antibiotics. Treatment is based on oral prescription of metronidazole for 10 days. In case of recurrence, immunotherapy and toxin-A blocking agents could be proposed.