Etiology of Community Acquired Clostridium Difficile-Associated Disease

A review of literature related to community acquired Clostridium difficile-associated disease (CA-CDAD) was conducted. Nine relevant studies were identified using the Cumulative Index to Nursing and Allied Health (CINAHL) and MEDLINE-EBSCOhost databases. Clinical practice recommendations were obtained from the Centers for Disease Control and Prevention. The studies provided information about epidemiology of infection due to C. difficile in the community and interventions to reduce transmission. Multiple studies found underlying gastrointestinal disorders and use of cephalosporin antibiotics to be a risk factor. Another risk factor was administration of gastric acid suppressive drugs. No particular C. difficile strain was more likely to cause recurrence. Many positive cases for CA-CDAD lacked traditional risk factors such as recent antibiotic exposure. To reduce transmission of CACDAD, it should be considered in the differential diagnosis of diarrhea. Clinicians should collect specimens for culture based on patient history and current clinical presentation for patients with diarrhea. It is important that patients be taught the proper hygiene and cleaning protocols to reduce transmission.