Current epidemiology and treatment of Clostridium difficile infection

With the emergence of B1/NAP1 strain of Clostridium difficile, epidemic feature of C. difficile infection (CDI) has been changing in North America. Clinical manifestation of CDI caused by B1/NAP1 strain is more severe resulting in high mortality and complications, and relapse rate is higher. In Korea, the epidemic feature of CDI is not clearly demonstrated yet. Infection by B1/NAP1 strain was reported recently, but the prevalence of the infections by those strains seems to be not high yet. For the management of CDI, conventional treatment of vancomycin or metronidazole is still the choice of treatment, however, several clinical trials of CDI treatment are progressing; fidaxomicin, monoclonal antibody, toxoid vaccine, and luminal nontoxigenic C. difficile infusion. Thus, it is expected to have more effective treatment or prevention modality of CDI in near future.