Clostridium difficile Associated Diarrhea: Diagnostic Challenges

Clostridium difficile associated diarrhea (CDAD) is a key indicator for monitoring the success of antibiotic stewardship programs in hospitals. Indiscriminate use of antimicrobials coupled with emergence of hyper virulent strains and inadequate infection control measures in hospitals have led to rise in incidence of CDAD. In India, CDAD is still an under recognized cause of diarrhea, due to lack of clinical suspicion, difficulty in culturing the organism and nonavailibility of other diagnostic assays due to their high costs. In Indian scenario, we need to generate data on the burden of the disease by conducting robust epidemiological studies. Diagnosis and management of CDAD is a challenge in best of the setups all over the world. There is a need for development of rapid, affordable, point of care gold standard diagnostic assays.