Community-Acquired Toxigenic Clostridium Difficile Diarrhoea in the Normoxaemic Elderly Who Have Received No Antimicrobials: Soft Evidence for Ischaemic Colitis?
Restricted accessResearch articleFirst published online February, 1996
Community-Acquired Toxigenic Clostridium Difficile Diarrhoea in the Normoxaemic Elderly Who Have Received No Antimicrobials: Soft Evidence for Ischaemic Colitis?
We report three examples of community-acquired toxigenic Clostridium difficile diarrhoea in elderly patients who had neither received antimicrobial therapy nor been institutionalised. These cases stimulated interest in the non-antimicrobial changes which might predispose the host to C. difficile-related disease and raised the spectre of bowel ischaemia as a possible aetiological factor.
FinneyJMT. Gastroenterostomy for cicatrizing ulcer of the pylorus. Bulletin of the John Hopkins Hospital1893; 4: 53–55.
2.
ReinkeCMMessickCR. Update on Clostridium difficile-induced colitis, part 1. Am J Hosp Pharm1994; 51: 1771–1781.
3.
HallJCO'TooleE. Intestinal flora in newborn infants with a description of a new pathogenic anaerobe, Bacillus difficilis, Am J Dis Child1935; 49: 390–402.
4.
BartlettJGMoonNChangTTaylorNOnderdonkAB. Role of Clostridium difficile in antibiotic-associated pseudomembranous colitis. Gastroenterology1978; 75: 778–782.
5.
LyerlyDMKrivanHCWilkinsTD. Clostridium difficile: Its disease and toxins. Clin Microbiol Rev1988; 1: 1–18.
6.
KellyCPPothoulakisCLaMontJT. Clostridium difficilecolitis. N Eng J Med1994; 330: 257–262.
7.
TaylorNSThomeGMBartlettJG. Comparison of two toxins produced by Clostridium difficile. Infect Immun1981; 34: 1036–1043.
8.
BorrielloSPKetleyJMMitchellTJBarclayFEWelchARPriceABStephenJ. Clostridium difficile –a spectrum of virulence and analysis of putative virulence determinants in the hamster model of antibiotic-associated colitis. J Med Microbiol1987; 24: 53–64.
9.
BartfettJG. Clostridium difficile: History of its role as an enteric pathogen and the current state of knowledge about the organism. Clin Infect Dis1993; 18 (Suppl4): S265–272.
10.
AronssonBMollbyRNordCE. Antimicrobial agents and Clostridium difficile in acute enteric disease: Epidemiological data from Sweden, 1980–1982. J Infect Dis1985; 151: 476–481.
11.
RolfeRDIaconisJP. Intestinal colonization of infant hamsters with Clostridium difficile. Infect Immun1983; 42: 480–486.
12.
ViscidiRWilleySBartlettJG. Isolation rates and toxigenic potential of Clostridium difficile isolates from various patient populations. Gastroenterology1981; 8I: 5–9
13.
McFarlandLVMulliganMEKwokRYYStammWE. Nosocomial acquisition of Clostridium difficile infection. N Engl J Med1989; 320: 204–210.
14.
NolanNPMKellyCPHumphreysJFHCooneyCO'ConnorRWalshTNWeirDGO'BriainDS. An epidemic of pseudomembranous colitis: The importance of person to person spread. Gut1987; 28: 1467–1473.
