Clostridium difficile is a topic covered in the Johns Hopkins HIV Guide.

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  • Spore-forming, anaerobic, gram-positive rod.
  • Produces toxins A and B, which bind to specific receptors in colon. Toxins attack Rho proteins, disrupting actin formation and causing cell death.
  • Studies show that toxin B, not toxin A, is essential for virulence.
  • Spores contaminate hands and hospital environment. Alcohol and other antiseptic hand rubs may be ineffective in killing spores. Hand-washing physically removes spores.
  • A hypervirulent strain (NAP1/B1/027) produces higher levels of toxins A and B and is associated with fluoroquinolone resistance, more severe disease, and higher mortality.

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Last updated: January 3, 2017