Educational resource · Not a medical device · Infectious diseases review in progress · Does not replace clinical judgement

Clostridioides difficile — C. difficile

Review by an infectious diseases specialist in progress · edited by a physician, AI-assisted writing · level of evidence computed from the source type · page as of 26 October 2026 · Methodology

Peptostreptococcaceae · Gram-positive anaerobe

1ère cause de diarrhée nosocomiale. Infection essentiellement colique (complication grave : mégacôlon toxique). Ribotype 027 : souche décrite comme hypervirulente (toxine binaire, résistance aux fluoroquinolones). Traitement 2024 : vancomycine, duration not verified — see cited source. Métronidazole : plus recommandé quand fidaxomicine ou vancomycine sont disponibles (ESCMID 2021). Rechute fréquente : bezlotoxumab (Ac anti-toxine B, NEJM 2017) ou transplantation de microbiote fécal (TMF/FMT — van Nood NEJM 2013 : 94% de guérison vs 31% vancomycine). À noter : SHA inefficaces sur les spores — lavage eau + savon recommandé.

Scope: dosing as described in the cited guidelines (French or international context, stated by the source), for adults with normal renal function unless stated on the line. No renal or hepatic, paediatric or pregnancy adjustment is provided systematically. These regimens have not been reviewed by any infectious-disease specialist to date.

Documented organ tropism

Organs where foci of Clostridioides difficile are described in the cited literature. The reported frequency is not an individual probability.

Organ	Tropism	Level of evidence	Sources	Spread route
Colon / Alimentary system (colite pseudomembraneuse)	High tropism	Evidence A	4	not recorded
Systémique (mégacôlon toxique)	Rare tropism	Evidence B	1	direct

Described portals of entry

• Colon / Alimentary system

Spread routes recorded: 1 of 2 documented foci A focus without a route is not a focus without spread: the route is simply not recorded.

Associated syndromes

• Infectious diarrhoea

Sources

• IDSA/SHEA — Clostridioides difficile Infection Guidelines (2021) — doi:10.1093/cid/ciab549
• ESCMID — 2021 update on the treatment guidance document for Clostridioides difficile infection in adults (van Prehn J et al., Clin Microbiol Infect) (2021) — doi:10.1016/j.cmi.2021.09.038
• van Nood E et al. — Fecal microbiota transplantation for CDI (NEJM) (2013) — doi:10.1056/NEJMoa1205037
• Leffler DA & Lamont — Clostridium difficile infection (NEJM) (2015) — doi:10.1056/NEJMra1403772
• Sailhamer EA et al. — Fulminant Clostridium difficile colitis: patterns of care and predictors of mortality (Arch Surg) (2009) — doi:10.1001/archsurg.2009.51

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