Community-acquired Clostridioides difficile infection: an overlooked diagnosis?
Authors:
A. Slámová; O. Džupová
Authors‘ workplace:
Fakultní nemocnice Bulovka, Klinika infekčních nemocí, Praha
; Univerzita Karlova, 3. lékařská fakulta, Klinika infekčních nemocí, Praha
Published in:
Prakt. Lék. 2026; 106(4): 135-140
Category:
Reviews
Overview
Clostridial colitis is a diarrhoeal disease caused by Clostridioides difficile that most often develops following antibiotic treatment and has been associated primarily with the hospital setting. Epidemiological data from recent decades, however, demonstrate the growing importance of the community-acquired form (community-acquired Clostridioides difficile infection, CA-CDI), which in Europe accounts for approximately one quarter of C. difficile infection (CDI) cases. Patients with CA-CDI tend to be younger and often lack the classic risk factors; the clinical presentation, diagnosis, and treatment do not, in principle, differ from the hospital-acquired form. The dominant modifiable risk factor remains exposure to antibiotics; antimicrobial stewardship therefore plays a key role in prevention. Toxigenic strains have been detected in soil, wastewater, food, and in both farm and companion animals. The spores are highly resistant to heat treatment, freezing, and common disinfection procedures, which facilitates persistence of the bacterium in the environment and the food chain. Genomic data suggest repeated introduction of diverse strains from these reservoirs rather than direct person-to-person transmission. This review summarizes the basic characteristics of the disease and current knowledge on the epidemiology, risk factors, and reservoirs of CA-CDI, and highlights that in the Czech Republic the community-acquired form remains outside national surveillance, and its true burden is likely underestimated.
Keywords:
surveillance – Clostridioides difficile – community-acquired infection – One Health – reservoirs – antimicrobial stewardship
Sources
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General Practitioner
2026 Issue 4
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