<i>Clostridioides difficile</i> Infection Recurrence in a 68-Year-Old Patient of the Internal Medicine Ward

Abstract

Introduction: Clostridioides difficile infection (CDI) is the most frequently identified health care-associated infection. Recurrent CDI is characterized by the reappearance of clinical symptoms along with a new positive test for C. difficile occurring within 2 to 8 weeks following the completion of therapy for the initial episode. It is estimated that approximately 30% of patients with an initial CDI will develop a first recurrence. Case Presentation: A 68-year-old female patient hospitalized in the internal medicine ward of a district hospital is described. Both isolated strains were resistant to erythromycin, clindamycin (confirmed by the ermB gene), moxifloxacin, imipenem, rifampicin, piperacillin with tazobactam, penicillin G, and chloramphenicol, and were identified as C. difficile ribotype 027 (RT027). Conclusions: This single-case report has illustrative value and highlights the importance of considering C. difficile strain characteristics, including toxigenicity, ribotype, and antibiotic susceptibility, when making treatment decisions, cohorting patients, and distinguishing between reinfection and recurrence of CDI.