Diverse Sources and Latent Reservoirs of Community-Associated Clostridioides difficile Infection

Clostridioides difficile is a spore-forming, toxin-producing, anaerobic bacterium that infects the human gastrointestinal tract, causing diarrhea and life-threatening colitis. Clostridioides difficile epidemiology continues to evolve, and it is recognized as a major community-associated (CA) pathogen in addition to its established role in causing healthcare-associated (HA) infection. While current surveillance and prevention measures mainly focus on healthcare-associated C. difficile infections (HA-CDI), much less is known about the factors that drive CA-CDI. This review highlights the potential contribution of reservoirs, including asymptomatic carriers, to CA C. difficile transmission. The reservoirs discussed in this review provide potential avenues for research to better understand and reduce CA transmission of C. difficile.