{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,23]],"date-time":"2026-10-23T20:04:05Z","timestamp":1792785845615,"version":"4.5.0"},"reference-count":51,"publisher":"Oxford University Press (OUP)","issue":"3","license":[{"start":{"date-parts":[[2026,6,12]],"date-time":"2026-06-12T00:00:00Z","timestamp":1781222400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"DOI":"10.13039\/100006474","name":"Columbia University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100006474","id-type":"DOI","asserted-by":"publisher"}]},{"name":"Columbia University Digestive and Liver Disease Research Center","award":["P30DK132710"],"award-info":[{"award-number":["P30DK132710"]}],"id":[{"id":"https:\/\/ror.org\/00hj8s172","id-type":"ROR","asserted-by":"crossref"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2026,10,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>This review combines historical reports and surveillance data to contextualize Clostridioides difficile infection (CDI) in the United States as a phased epidemic, currently in the deceleration phase. C. difficile was first isolated in 1935. During a prolonged emergence phase, the organism attracted limited clinical attention. In 1978, C. difficile was established as the cause of antibiotic-associated pseudomembranous colitis and from 1978 to a peak in 2010, CDI was in an acceleration phase characterized by fluoroquinolone-resistant, toxin-overproducing strains, large hospital outbreaks, and incidence rates over 150 per 100 000 population. Beginning around 2010, CDI incidence decreased, with a shift from healthcare-associated to community-acquired CDI. Changes in diagnostics complicate incidence comparison between phases; only recently is it apparent that CDI has entered a deceleration phase characterized by infectious reservoirs and possible increases in immunity. It may behoove us to prepare for a different kind of CDI: community-based and insidious rather than hospital-predominant and explosive.<\/jats:p>","DOI":"10.1093\/cid\/ciag363","type":"journal-article","created":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T11:47:05Z","timestamp":1781178425000},"page":"401-407","source":"Crossref","is-referenced-by-count":2,"title":["The Phases of\n                    <i>Clostridioides difficile<\/i>\n                    Infection (CDI) in the United States: The History and Epidemiology of CDI From 1935 to Present"],"prefix":"10.1093","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-8056-9436","authenticated-orcid":false,"given":"Om B","family":"Kar","sequence":"first","affiliation":[{"name":"Department of Biological Sciences, Columbia University , NewYork, New York ,","place":["USA"]},{"name":"Department of Systems Biology, Columbia University , NewYork, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2023-2899","authenticated-orcid":false,"given":"Daniel E","family":"Freedberg","sequence":"additional","affiliation":[{"name":"Department of Medicine, Vagelos College of Physicians and Surgeons, Columbia University Irving Medical Center , NewYork, New York ,","place":["USA"]},{"name":"Department of Epidemiology, Mailman School of Public Health, Columbia University , NewYork, New York ,","place":["USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,6,12]]},"reference":[{"key":"2026100713432563000_ciag363-B1","author":"CDC"},{"key":"2026100713432563000_ciag363-B2","doi-asserted-by":"crossref","first-page":"390","DOI":"10.1001\/archpedi.1935.01970020105010","article-title":"Intestinal flora in new-born infants: with a description of a new pathogenic anaerobe, Bacillus difficilis","volume":"49","author":"Hall","year":"1935","journal-title":"Am J Dis Child"},{"key":"2026100713432563000_ciag363-B3","doi-asserted-by":"crossref","first-page":"311","DOI":"10.1128\/jb.79.2.311-312.1960","article-title":"Intestinal flora of some antarctic birds and mammals1","volume":"79","author":"McBee","year":"1960","journal-title":"J Bacteriol"},{"key":"2026100713432563000_ciag363-B4","doi-asserted-by":"crossref","first-page":"65","DOI":"10.1128\/jb.84.1.65-67.1962","article-title":"Occurrence of clostridium difficile in infections of man","volume":"84","author":"Smith","year":"1962","journal-title":"J Bacteriol"},{"key":"2026100713432563000_ciag363-B5","doi-asserted-by":"crossref","first-page":"2177","DOI":"10.1001\/archinte.162.19.2177","article-title":"The Spectrum of pseudomembranous enterocolitis and antibiotic-associated diarrhea","volume":"162","author":"Hurley","year":"2002","journal-title":"Arch Intern Med"},{"key":"2026100713432563000_ciag363-B6","doi-asserted-by":"crossref","first-page":"429","DOI":"10.7326\/0003-4819-81-4-429","article-title":"Clindamycin-associated colitis. 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