When Does Clostridioides difficile “Recur”? Reconcile Epidemiologic & Bedside Recurrent CDI definitions

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ID: 317648
2026
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Abstract
Recurrent Clostridioides difficile infection (CDI) is a clinical syndrome, a trial endpoint, and a surveillance construct. Epidemiologic and administrative datasets count repeat positive tests or coded episodes, but conflate colonization or test of cure with recurrence. Trials operationalize recurrent CDI with symptoms, testing, but have variable follow-up. Clinically, recurrent CDI requires response, and recurrent illness excluding post-infection bowel dysfunction and mimics. Relapse and reinfection remain difficult to distinguish without strain typing which is more relevant for research. We propose a pragmatic lens: explicitly name the definition used, match it to the decision, and adjudicate clinical recurrence before escalating therapy.
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openalex_W7165010862 Use this key to autocite in the manuscript while using SciMatic Manuscript Manager or Thesis Manager
Authors Sahil Khanna, Paul Feuerstadt, J Allegretti, Darrell S Pardi
Journal The Journal of infectious diseases
Year 2026
DOI
10.1093/infdis/jiag307
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