Clostridioides difficile

Clostridioides difficile (previously: Clostridium difficile) is an anaerobic, Gram-positive, endospore-forming rod-shaped bacterium that belongs to the genus Clostridioides.

Clostridioides difficile is considered the most common causative agent of nosocomial and antibiotic-associated gastrointestinal infections. The hypervirulent ribotype 027 causes severe disease worldwide. Clostridioides difficile causes the following diseases:

  • Nonspecific diarrheal diseases

  • Antibiotic-associated diarrhea/colitis

  • Pseudomembranous colitis

Clostridioides difficile is spread worldwide. Spores are found primarily in soil. In the healthy population 3-5% and in hospitalized patients 15-35% are colonized with the pathogen without symptoms of disease.

Relevance of pathogen in transmission in endoscopy

  • Gastroenterology: Very high

  • Pulmonology: Not relevant

  • Ear, nose, and throat: Not relevant

  • Urology: Not relevant

Relevance for endoscope surveillance

  • High concern organism

Transmission route

Transmission via the fecal–oral route is particularly relevant, but indirect transmission via contaminated surfaces, objects, or hands of nursing staff also comes into consideration. Inadequate basic hygiene is one of the risk factors for transmission.

Resistance to antibiotics

Clostridioides difficile is resistant to many classes of antibiotics such as penicillins, cephalosporins, and aminoglycosides.

Find more information here:
Clostridioides difficile: Relevance, ribotypes, and endoscope reprocessing.

Sources and further readings

  1. Clostridioides difficile in Healthcare Settings, Centers for Disease Control and Prevention, Accessed on 06.21.2021.

  2. Gries O, Ly T: Infektologie – Kompendium humanpathogener Infektionskrankheiten und Erreger, Springer-Verlag Berlin Heidelberg 2019.

  3. Hygienemaßnahmen Clostridioides difficile-Infektion (CDI), Empfehlung der Kommission für Krankenhaushygiene und Infektionsprävention (KRINKO) beim Robert Koch-Institut (RKI), Bundesgesundheitsbl 2019 · 62:906–923.

  4. Selinger CP et al. 2010. Is gastrointestinal endoscopy a risk factor for Clostridium difficile associated diarrhea? Am. J. Infect. Control 38:581–582.