Survey on the diagnosis and treatment of Clostridium difficile infection

The toxigenic strains of Clostridioides (Clostridium) difficile is the most common pathogen of nosocomial and antibiotic-related diarrhoea in healthcare facilities. Lately, there has been an increase in the incidence of C. difficile infection (CDI) cases in Slovakia.

Retrospective analysis of the CDI appearance was carried out in the Zilina region. Additionally, an electronic survey focused on the diagnosis and treatment management of C. difficile infection was conducted among leading clinicians of the wards where CDI was present.

Eighty percent of clinicians reported that they were following the recommendations for diagnosis and treatment of C. difficile infection in their everyday practice. The majority of leading physicians were from internal medicine wards (50 %). Most respondents stated that the laboratory results correlated with the clinical symptoms of patients. The first-choice treatment of C. difficile infections was reported to be oral vancomycin (in 21.7 %) and oral metronidazole (in 47.8 %). The estimate of first-choice treatment success rate was 80 %, while the recurrence rate and severe course was observed in 20%. Vancomycin was the standard treatment for recurrent infection. It was administered orally either alone (31 %) or combined with metronidazole (38 %) or fidaxomicin (31 %).

The results of the survey showed that recommendations for the diagnosis and treatment were implemented in the wards of hospitals and showed the awareness of the necessity of rapid diagnosis and early treatment of C. difficile infection in patients (Fig. 4, Ref. 30).