People without a history of gastrointestinal disturbances due to antibiotic use or diarrheal illness are less likely to become colonized by C. difficile.In 2005, molecular analysis led to the identification of the C. difficile strain type characterized as group BI by restriction endonuclease analysis, as North American pulse-field-type NAP1 by pulsed-field gel electrophoresis  and as ribotype 027; the differing terminology reflects the predominant techniques used for epidemiological typing. This strain is referred to as C. difficile BI/NAP1/027. Risk factors
Antibiotics
C. difficile colitis is associated most strongly with the use of these antibiotics: fluoroquinolones, cephalosporins, and clindamycin.Some research suggests the routine use of antibiotics in the raising of livestock is contributing to outbreaks of bacterial infections such as C. difficile. Healthcare environment
People are most often infected in hospitals, nursing homes, or other medical institutions, although infection outside medical settings is increasing. Individuals can develop the infection if they touch objects or surfaces that are contaminated with feces and then touch their mouth or mucous membranes. Healthcare workers could possibly spread the bacteria or contaminate surfaces through hand contact. The rate of C. difficile acquisition is estimated to be 13% in those with hospital stays of up to two weeks, and 50% with stays longer than four weeks.Long-term hospitalization or residence in a nursing home within the previous year are independent risk factors for increased colonization.
Installing lidded toilets and closing the lid prior to flushing also reduces the risk of contamination.Those who have CDIs should be in rooms with other people with CDIs or by themselves when in hospital.Common hospital disinfectants are ineffective against C. difficile spores, and may promote spore formation, but various oxidants   (e.g 1% sodium hypochlorite solution) rapidly destroy spores. Hydrogen peroxide vapor (HPV) systems used to sterilize a room after treatment is completed have been shown to reduce infection rates and to reduce risk of infection to others. The incidence of CDI was reduced by 53% or 42% through use of HPV. Ultraviolet cleaning devices, and housekeeping staff especially dedicated to disinfecting the rooms of people with C. difficile after discharge may be effective. Treatment
Carrying C. difficile without symptoms is common. Treatment in those without symptoms is controversial. In general, mild cases do not require specific treatment. Oral rehydration therapy is useful in treating dehydration associated with the diarrhea. Medications
Several different antibiotics are used for C. difficile, with the available agents being more or less equally effective.Vancomycin or fidaxomicin by mouth are the typically recommended for mild, moderate, and severe infections. They are also the first-line treatment for pregnant women, especially since metronidazole may cause birth defects. Typical vancomycin 125mg is taken four times a day by mouth for 10 days. Fidaxomicin is taken at 200 mg twice daily for 10 days.