History:
C. difficile was first identified in 1935 by scientists Elizabeth O'toole and Ivan C. Hall[1]. They were examining the normal micro flora in the intestines and stool of newborns when they cultured a new bacterium. It wasn't until 1974 when Hafiz published an article on the different characteristics of the bacterium C. difficile which gathered basic information about the bacterium[2]. He looked at the appearance, what agar the bacterium grew in, the survival in different mediums, different biochemical reactions, and a small amount about the toxins that C. difficile produced.
The bacterium was not thought to be associated with human disease until the antibiotic era emerged. One of the diseases to emerge during this era was pseudomembranous colitis (PMC), today known as Clostridium difficile infection (CDI). In 1974, FJ Tedesco, noticed that patients receiving the antibiotic clindamycin were developing diarrhea. After conducting a study on these patients he found that 10% of his patients also had PMC. Still there was no connection of C. difficile to human disease[3].
Finally in 1978, TW Chang and J.G . Bartlett, performed a study that took samples from a patient with PMC and a hamster with clindamycin-induced entercolitis and compared the toxins using a cytotoxicity assay. This showed that the toxins were very similar. They then used a clostridial antitoxin to neutralize the toxicity, and it worked. Chang and Berlett then cultured the samples and found C. difficile bacteria[4]. Later, in 1978, the same scientists published a paper that linked Clostridium difficile as the cause of antibiotic associated PMC[5].
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- ^ Hall, Ivan C (1935). "Intestinal flora in newborn infants: with a description of a new pathogenic anaerobe, Bacillus difficilis". Am J Dis Child. 49: 390–42.
- ^ Hafiz, S (1976). "Clostridium difficile: isolation and characteristics (Plate VIII)". Journal of Medical Microbiology. 9: 129–136.
- ^ Tedesco, FJ (1974). "Clindamycin-Associated Colitis: A Prospective Study". Ann Intern Med. 81: 429–433.
- ^ Bartlett, J.G. (1978). "Clindamycin-induced enterocolitis in hamsters as a model of pseudomembranous colitis in patients". Infect Immun. 20: 526–529.
- ^ Bartlett, J.G. (1978). "Antibiotic-associated pseudomembranous colitis due to toxinproducing clostridia". New England Journal of Medicine. 298: 531–534.
- ^ Burnham, Carey-Ann D. (2013). "Diagnosis of Clostridium difficile Infection: an Ongoing Conundrum for Clinicians and for Clinical Laboratories". Clinical Microbiology Reviews. 26: 604–630.