Dr. Nabili received his undergraduate degree from the University of California, San Diego (UCSD), majoring in chemistry and biochemistry. He then completed his graduate degree at the University of California, Los Angeles (UCLA). His graduate training included a specialized fellowship in public health where his research focused on environmental health and health-care delivery and management.
Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.
Clostridium is a family of bacteria containing several members. Some of the
other well known bacteria in this group include Clostridium botulinum and
Clostridium tetani, which are the causes of botulism and tetanus, respectively.
There are typically two forms of Clostridium difficile; one is the inactive
or non-infectious form, called the spore, and the other is the active and
infectious form. The spore form can survive in the environment for a long time,
whereas the active form cannot.
Clostridium difficile colonize the intestinal tract by the oral route
following the disruption of the balance of normal colonic bacteria (normal flora), which is
usually due to the use of antibiotics. Although C. diff spores may reside in the
active form in the colon of some individuals (carrier state), they can also be
ingested in this form (fecal-oral transmission).
After being shed in the stool, C. diff may be found residing in many places,
especially in hospitals, nursing homes, and other health care facilities.
The common locations
of the C. diff include:
toilet seats, and
other objects commonly used by patients and health care
During the last 10 years, C. difficile infections have been observed to be more frequent, severe, and resistant to standard therapy. This is linked to the emergence of new strains of C. difficile and continued increase use of antibiotics. Large out breaks of C. difficile infections have been observed throughout North America and Europe. Not only are the incidence of these infections increasing in the hospital setting but they are also occurring in the community setting (community acquired infections ).
A report in October 2012 found C. difficile present in hospital food
at one facility.
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Clostridium difficile: A bacterium that is one of the most common causes of infection of the colon in the US. Patients taking antibiotics are at risk of becoming infected with C. difficile as antibiotics can disrupt the normal bacteria of the bowel, allowing C. difficile to become established in the colon. In some people, a toxin produced by C. difficile causes diarrhea, abdominal pain, severe inflammation of the colon (colitis), fever, an elevated white blood cell count, vomiting, and dehydration. In severely affected patients, the inner lining of the colon becomes severely inflamed (pseudomembranous colitis) with the potential to perforate.