[ES]Introducci?n: Clostridioides difficile es el agente causante del cuadro diarreico m?s frecuente en el ?mbito hospitalario. Est? relacionado con la alteraci?n de la microbiota intestinal, debida al consumo de antibi?ticos y de inhibidores de la bomba de protones, a edades avanzadas y a la enfermedad inflamatoria intestinal, entre otros. El diagn?stico se basa en la detecci?n de sus toxinas y, como tratamiento de primera l?nea se emplean vancomicina y/o fidaxomicina. Objetivos: Conocer la situaci?n epidemiol?gica de la infecci?n por C. difficile y las expectativas terap?uticas existentes. Material y m?todos: Se realiz? una revisi?n bibliogr?fica sistem?tica. Se han seleccionado 64 art?culos, elegidos en base a unos criterios de exclusi?n e inclusi?n. La b?squeda ha sido efectuada en las bases de datos online PubMed, Google Acad?mico y Cochrane. Resultados y discusi?n: Se investigaron las diferencias epidemiol?gicas entre Espa?a, Europa y Estados Unidos, analizando la distribuci?n de ribotipos de C. difficile, la posible transmisi?n por alimentos o zoon?tica en Europa y la eficacia de los tratamientos disponibles. Adem?s, se recopil? informaci?n acerca de medidas terap?uticas y profil?cticas en estudio, destacando aquellas basadas en la microbiota intestinal. Conclusiones: La infecci?n por C. difficile sigue siendo una de las m?s relevantes a nivel nosocomial, observ?ndose tambi?n un aumento en la incidencia de casos comunitarios. Los ribotipos altamente virulentos (toxinotipo IIIb) se han identificado en varios pa?ses. Es importante desarrollar e implementar nuevas medidas profil?cticas y terap?uticas para reducir la incidencia y morbi-mortalidad asociadas con esta infecci?n.

[EN]Introduction: Clostridioides difficile is the causative agent of the most common diarrheal disease at hospitals. It is associated with alterations in the intestinal microbiota, which are due to antibiotic and proton pump inhibitors consumption, advanced age and inflamatory bowel disease, among other factors. Diagnosis is based on the detection of its toxins and, as first - line treatments vancomicin and/or fidaxomicin are used. Objectives: To understand the epidemiological situation of C. difficile infection and the present therapeutic expectations. Material and methods: A systematic literature review was conducted. A total of 64 articles were chosen based on exclusion and inclusion criteria. The search was performed in online databases including PubMed, Google Scholar and Cochrane. Results and discussion: Epidemiological differences between Spain, Europe and the USA were investigated, analyzing the distribution of C. difficile ribotypes, the potential transmission through food or zoonotic means in Europe, and the efficacy of available treatments. Additionally, information on therapeutic and prophylactic measures under study was compiled, highlighting those based on intestinal microbiota. Conclusions: C. difficle infection remains one of the most relevant nosocomial infections, with an observed increase in comunity - associated cases. Highly virulent ribotypes (toxinotype IIIb) have been identified in several countries. It is important to develop and implement new prophylactic and therapeutic measures in order to reduce the incidence, morbidity and mortality of this infection.

Trabajo de fin de grado. Grado en Medicina. Curso acad?mico 2023-2024