Clostridioides

Clostridioides (commonly named Clostridium difficile) is the most common cause of hospital-acquired infectious diarrhea in the developed world, has re-emerged in recent years with increasing incidence and severity. The clinical spectrum of C. difficile infection (CDI) varies in severity from asymptomatic carriage and self-limited, to pseudomembranous colitis, sepsis, and death. Prevention and eradication of CDI require a multidisciplinary approach, including early disease recognition through appropriate surveillance, implementation of effective contact isolation strategies, adherence to environmental controls, judicious hand hygiene, evidence-based treatment, and management that includes antibiotic stewardship, continuous education of healthcare workers, and administrative support.

Different elements are explored in details (risk factors related to relapse, outcome of patients, symptoms, colonization…) in the following projects:

- Prospective active surveillance and impact on nosocomial transmission.

- C. difficile infection in patients hospitalized in a large tertiary hospital - Lyon: a cohort prospective study to describe the prognosis in patients suffering from diarrhea suspected to be related to C. difficile (collaborative study with Sanofi Pasteur).

- Factors associated with CDI and colonization: a cohort prospective study to estimate the proportion of asymptomatic colonization at admission and during hospitalization, to identify factors associated with colonization and infection and to estimate the delay between the acquisition of C. difficile and the onset of symptoms related to CDI (collaborative study with FINOVI).

- Host immune response in patients infected by C. difficile and the impact on prognosis: a cohort prospective study to evaluate the relation between relapses and levels of anti-toxin A and anti-toxin B antibodies and to develop a risk prediction tool of relapses including antibodies anti toxins A&B (collaborative study with HCL and MSD).