Sep 23, 2026 · 26 min · 8 segments
Welcome to the rebroadcast six-episode series: C. difficile: Preparing the Field for Change. This program will explore how to take a patient-centered approach to treatment and diagnosis, explore…
Paul FeuerstadtGuest
Sahil KhannaHost
Well, as you know, and a lot of our audience may know, that C. difficile is an urgent public health threat by the CDC.
There's about a half a million people in the United States who get this infection every year, and people get recurrences.
You know, that's a really important question, Sahil, and I think something that we grapple with on a daily basis, but a lot of clinicians also grapple with on a daily basis.
And people who get C. difficile are largely, I think, grouped into kind of three categories, demographics, medication exposures, and environmental risk factors.
And I know that it's important when we think about the risk factors to kind of consider the modifiable risk factors and the non-modifiable risk factors.
So from a demographical standpoint, Anybody over the age of 65, female gender, any form of immune compromise, chronic kidney disease, HIV, inflammatory bowel disease.
Whenever you look at a clinical trial, whenever you consider data in the C. difficile space, it appears that about 60% of the patients are women.
Do you have any insight to why that might be? Now, I haven't seen anything in the literature.
So what is your thought for why so many women or it's really 60, 40 women to men?
We did some work and we figured out, is it because women are getting more antibiotics than men or seeking more healthcare or getting more urinary tract infections because we see a woman preponderance in that? And the answer is really no.
is there something inherent in the gut microbiome which is different between men and women the answer could lie there but the answer definitely lies where we have to study what the microbiome looked like before the antibiotic exposure what happened during the antibiotic exposure and then does cd facile exposure to men and women affects them differently the answer probably lies in there i just don't know we have that answer at this point yes we've seen that Paul, the other point that you just pointed out was the majority of people are over the age of 65.
The answer really is that you and I are both exposed to C. difficile all the time.
Well, as you know, and a lot of our audience may know, that C. difficile is an urgent public health threat by the CDC.
There's about a half a million people in the United States who get this infection every year, and people get recurrences.
You know, that's a really important question, Sahil, and I think something that we grapple with on a daily basis, but a lot of clinicians also grapple with on a daily basis.
And people who get C. difficile are largely, I think, grouped into kind of three categories, demographics, medication exposures, and environmental risk factors.
And I know that it's important when we think about the risk factors to kind of consider the modifiable risk factors and the non-modifiable risk factors.
So from a demographical standpoint, Anybody over the age of 65, female gender, any form of immune compromise, chronic kidney disease, HIV, inflammatory bowel disease.
Whenever you look at a clinical trial, whenever you consider data in the C. difficile space, it appears that about 60% of the patients are women.
Do you have any insight to why that might be? Now, I haven't seen anything in the literature.
So what is your thought for why so many women or it's really 60, 40 women to men?
We did some work and we figured out, is it because women are getting more antibiotics than men or seeking more healthcare or getting more urinary tract infections because we see a woman preponderance in that? And the answer is really no.
is there something inherent in the gut microbiome which is different between men and women the answer could lie there but the answer definitely lies where we have to study what the microbiome looked like before the antibiotic exposure what happened during the antibiotic exposure and then does cd facile exposure to men and women affects them differently the answer probably lies in there i just don't know we have that answer at this point yes we've seen that Paul, the other point that you just pointed out was the majority of people are over the age of 65.
The answer really is that you and I are both exposed to C. difficile all the time.
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