{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,30]],"date-time":"2025-12-30T17:56:08Z","timestamp":1767117368127,"version":"3.44.0"},"reference-count":96,"publisher":"Microbiology Society","issue":"4","license":[{"start":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T00:00:00Z","timestamp":1745452800000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,4,24]]},"abstract":"<jats:p>\n                  <jats:italic>\n                     <jats:named-content content-type=\"#213368\">A corrigendum of this article has been published full details can be found at <\/jats:named-content>\n                  <\/jats:italic>\n                  <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"uri\" xlink:href=\"https:\/\/doi.org\/10.1099\/jmm.0.002062\" xlink:type=\"simple\">https:\/\/doi.org\/10.1099\/jmm.0.002062<\/jats:ext-link>\n               <\/jats:p>\n               <jats:p>\n                  <jats:italic>Clostridioides difficile<\/jats:italic> (formerly known as <jats:italic>Clostridium difficile<\/jats:italic>) is a significant cause of healthcare-associated infection with symptoms ranging from diarrhoea and abdominal pain to pseudomembranous colitis and toxic megacolon. Severe disease can pose a significant morbidity and mortality risk and is to be considered a medical emergency. The emergence of a new <jats:italic>C. difficile<\/jats:italic> ribotype with an estimated mortality rate of 20% (ribotype 995) has prompted a re-review of the evidence and guidelines around managing severe <jats:italic>C. difficile<\/jats:italic> infections (CDI). International guidance on the management of CDI varies regarding first-line antibiotic choice. Metronidazole is no longer favoured as first line due to concerns around resistance, and vancomycin and fidaxomicin are now recommended as first line options. Antibiotic therapy should be used in conjunction with good supportive measures and early consideration of surgical management. Faecal microbiota transplant can be utilized in recurrent CDI and may be useful in severe disease. Severe CDI is a significant ongoing threat to public health, and further research into effective management is essential to ensure the best possible outcomes for patients.<\/jats:p>","DOI":"10.1099\/jmm.0.001991","type":"journal-article","created":{"date-parts":[[2025,4,24]],"date-time":"2025-04-24T12:15:58Z","timestamp":1745496958000},"source":"Crossref","is-referenced-by-count":4,"title":["Management of severe and fulminant Clostridioides difficile infection in adults"],"prefix":"10.1099","volume":"74","author":[{"given":"Daisy","family":"Ubsdell","sequence":"first","affiliation":[{"name":"Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola Louise","family":"Maddox","sequence":"additional","affiliation":[{"name":"Royal Devon University Healthcare NHS Foundation Trust and North Bristol NHS Trust, Bristol, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ray","family":"Sheridan","sequence":"additional","affiliation":[{"name":"Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"345","reference":[{"article-title":"Clostridioides difficile infection","year":"2024","author":"Mada","key":"R1"},{"key":"R2","doi-asserted-by":"publisher","DOI":"10.1038\/nrmicro.2016.108"},{"key":"R3","doi-asserted-by":"publisher","DOI":"10.1128\/AEM.00718-10"},{"year":"2023","key":"R4","article-title":"NICE clinical knowledge summaries. 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