Clostridium difficile infection, short history, evolution from hospital hallways to community- acquired infection

The anaerobic pathogen Clostridioides difficile has long been recognized as the leading cause of hospital-acquired diarrhea and pseudomembranous colitis. The primary risk factor for infection is broad-spectrum antibiotic use. The disease course is often severe and can be fatal. Over the past few decades, the incidence of C. difficile infection (CDI) has been increasing, with sporadic cases emerging in the community. However, the 21st century marked a significant epidemiological shift, characterized by a rising number of community-acquired cases. This trend primarily affects younger individuals, often in the absence of traditional risk factors, and the disease frequently presents with severe manifestations and recurrences. What underlies this phenomenon? This article explores the history and epidemiology of C. difficile-associated diarrhea.