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Antibiotic associated diarrhoea and enterocolitis

C Vaishnavi1

  • 1Department of Gastroenterology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.

Tropical Gastroenterology : Official Journal of the Digestive Diseases Foundation
|June 5, 1998
PubMed
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Clostridioides difficile causes antibiotic-associated diarrhea (AAD) and pseudomembranous colitis (PMC) through toxin production. Effective strategies for managing silent carriers of this bacterium remain unknown.

Area of Science:

  • Microbiology
  • Gastroenterology
  • Infectious Diseases

Background:

  • Clostridioides difficile is a primary cause of antibiotic-associated diarrhea (AAD) and pseudomembranous colitis (PMC).
  • Disease results from the overgrowth of endogenous or exogenous C. difficile strains following disruption of normal gut flora.
  • C. difficile produces toxins A and B, which damage the colonic mucosa, leading to necrosis and pseudomembrane formation in severe cases.

Purpose of the Study:

  • To review the etiology and investigation strategies for C. difficile-associated diseases.
  • To highlight the challenges in managing asymptomatic carriers of C. difficile.

Main Methods:

  • Review of existing literature on C. difficile pathogenesis and diagnostics.
  • Discussion of toxin detection methods, including neutralization assays with C. sordellii antitoxin.

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  • Analysis of treatment strategies and their limitations, particularly for carrier states.

    • Main Results:

    • C. difficile toxins A and B are key virulence factors causing mucosal damage.
    • Toxin neutralization assays offer a sensitive and straightforward method for C. difficile toxin detection.
    • Current antibiotic treatments may inadvertently promote C. difficile-associated enteric disease in carriers.

    Conclusions:

    • C. difficile infection presents a significant clinical challenge due to its varied presentation and toxin production.
    • Simple and sensitive diagnostic methods for C. difficile toxins are available.
    • Effective interventions for asymptomatic C. difficile carriers are lacking, and antibiotic use can be counterproductive.