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Clostridium difficile was first isolated and identified as a cause of diarrhea nearly 30 years ago. About 5 years ago, investigators in Quebec documented a remarkable increase in the incidence of C. difficile infection, with rates 4 times higher than historical rates in the overall population and 10 times higher in people older than 65. A recent review article presents updated information on this epidemic.
The disease is now 20 times more common in people older than 65 than in those younger than 20. The increase in incidence is particularly pronounced in hospitalized patients. The rise in incidence has been accompanied by markedly greater severity, with increased rates of toxic megacolon, severe hypoalbuminemia, shock, death (mortality rate,…