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This free activity, entitled “Clostridium difficile Infection: Tracking a Virulent Pathogen,” consists of four presentations and panel Q&A, a Learning Assessment, and an Evaluation form. The content of this virtual lecture is derived from a symposium presented on June 10, 2009, during the 2009 36th APIC Annual Conference.

MEDIA: Virtual Lecture or Podcast
(Continuing education credit is no longer available for this activity.)

Estimated time to complete this activity: 2 hours


This activity has been designed to meet the educational needs of physicians, pharmacists, and registered nurses involved in the care of patients with Clostridium difficile infection.

This activity is intended to provide healthcare professionals with clinical information that will contribute to improving competence in the management of patients with Clostridium difficile infection.

In recent years, the rates and severity of Clostridium difficile infection (CDI) have been increasing.1 This trend may be the result of changes in the epidemiology of C. difficile that may reflect changes in antimicrobial use, other drug-prescribing practices, or infection control practices.2 The increasing rates of CDI may also be the result of a new strain of C. difficile, one that appears to produce greater quantities of toxins A and B, is more resistant to fluoroquinolones, and is associated with higher rates of morbidity and mortality.3,4 Healthcare professionals should be aware of the changing epidemiology of this increasingly virulent pathogen and apply evidence-based principles for the prevention, diagnosis, and treatment of CDI.

1. McDonald LC, et al. Emerg Infect Dis. 2006;12:409-415.
2. Centers for Disease Control and Prevention. Fact Sheet, July 2005.
3. Warny M, et al. Lancet. 2005;366:1079-1084.
4. McDonald LC, et al. N Engl J Med. 2005;353:2433-2441.

After completing this activity, the participant should be better able to:

  • Review the changing epidemiology of C. difficile
  • Outline advantages and disadvantages of current diagnostic methods for C. difficile
  • Cite evidence-based strategies for the treatment of C. difficile infection (CDI)
  • Identify methods for the prevention and control of CDI

There are no fees for participating and receiving continuing education credit for this activity. During the period August 11, 2009, through August 11, 2010, participants must 1) read the learning objectives and faculty disclosures; 2) study the educational activity; 3) complete the Learning Assessment by recording the best answer to each question in the "Learning Assessment Answers" box on the Evaluation form; 4) complete the Evaluation form; and 5) mail or fax the Evaluation form with the Learning Assessment answers to Postgraduate Institute for Medicine. You may also complete the Learning Assessment online at www.cmeuniversity.com. Click on "Find Post-Test/Evaluation by Course" on the navigation menu, and search by Project ID 6528.

Participants must receive a score of at least 70% on the Learning Assessment and must complete and submit the Evaluation form to successfully complete this activity. Participants who successfully complete the Learning Assessment and Evaluation form via www.cmeuniversity.com will have a statement of credit made available immediately. Participants who successfully complete this activity and submit the Learning Assessment and Evaluation form via fax or mail will be issued a statement of credit via US mail in 4 to 6 weeks.

This activity has been planned and implemented in accordance with the Essential Areas and policies of the Accreditation Council for Continuing Medical Education (ACCME) through the joint sponsorship of Postgraduate Institute for Medicine (PIM) and Robert Michael Educational Institute LLC (RMEI). PIM is accredited by the ACCME to provide continuing medical education for physicians.

Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.0 AMA PRA Category 1 Credits™. Physicians should only claim credit commensurate with the extent of their participation in the activity.

Postgraduate Institute for Medicine is accredited by the Accreditation Council for Pharmacy Education as a provider of continuing pharmacy education.

Postgraduate Institute for Medicine designates this educational activity for a maximum of 2.0 contact hours (0.2 CEUs) of the Accreditation Council for Pharmacy Education. (Universal Activity Number – 809-999-09-098-H01-P).

A statement of credit will be issued only upon receipt of a completed activity Evaluation form and will be mailed to you within 3 weeks.

If you have received credit for UAN 809-999-09-072-L01-P, you are not eligible for this activity.

This educational activity for 2.0 contact hours is provided by Postgraduate Institute for Medicine (PIM).

PIM is accredited as a provider of continuing nursing education by the American Nurses Credentialing Center’s Commission on Accreditation.


PIM is approved by the California Board of Registered Nursing, Provider Number 13485 for 2.4 contact hours.

Stuart Johnson, MD, DTM&H
Associate Professor of Medicine
Loyola University Medical Center
Stritch School of Medicine
Maywood, Illinois
Staff Physician
Hines Veterans Affairs Hospital
Hines, Illinois

Dale N. Gerding, MD, FACP, FIDSA
Professor of Medicine
Loyola University Chicago Stritch School of Medicine
Maywood, Illinois
Associate Chief of Staff for Research and Development
Hines Veterans Affairs Hospital
Hines, Illinois

Ciarán P. Kelly, MD
Associate Professor of Medicine
Harvard Medical School
Director, Gastroenterology Fellowship Training
Beth Israel Deaconess Medical Center
Chief, Herrman L. Blumgart Internal Medicine Firm
Boston, Massachusetts

Keith S. Kaye, MD, MPH
Professor of Medicine
Wayne State University
Corporate Director
Infection Prevention, Epidemiology, and Antimicrobial Stewardship
Detroit Medical Center
Detroit, Michigan

Postgraduate Institute for Medicine (PIM) assesses conflict of interest with its instructors, planners, managers and other individuals who are in a position to control the content of continuing education (CE) activities. All relevant conflicts of interest that are identified are thoroughly vetted by PIM for fair balance, scientific objectivity of studies utilized in this activity, and patient care recommendations. PIM is committed to providing its learners with high-quality CE activities and related materials that promote improvements or quality in healthcare and not a specific proprietary business interest of a commercial interest.

The faculty reported the following financial relationships or relationships to products or devices they or their spouse/life partner have with commercial interests related to the content of this CE activity:

  • Dr. Stuart Johnson has affiliations with Genzyme Corporation; ViroPharma Incorporated; Salix Pharmaceuticals, Inc.; Acambis; Replidyne, Inc.; Optimer Pharmaceuticals, Inc.; and BD Diagnostics GeneOhm (Consultant).
  • Dr. Dale N. Gerding has affiliations with ViroPharma Incorporated (Patents); Cepheid; BD Diagnostics GeneOhm; Massachusetts Biologics Laboratories; Merck & Co., Inc.; GOJO Industries, Inc.; Optimer Pharmaceuticals, Inc.; Salix Pharmaceuticals, Inc.; Schering-Plough; and ViroPharma Incorporated (Research Grants and Consultant).
  • Dr. Ciarán P. Kelly has affiliations with Actelion Pharmaceuticals (Consultant and Research Grants); Salix Pharmaceuticals, Inc.; Cubist Pharmaceuticals, Inc.; and ViroPharma Incorporated (Consultant).
  • Dr. Keith S. Kaye has affiliations with Cubist; Merck & Co., Inc.; Pfizer Inc.; Schering-Plough (Speakers’ Bureau); Forest Laboratories, Inc.; Ortho-McNeil Pharmaceutical, Inc.; Schering-Plough; TheraDoc Inc.; Wyeth Pharmaceuticals (Consultant); Merck & Co., Inc. and Pfizer Inc. (Research).

The following planners and managers have the following to disclose:

Robert Michael Educational Institute LLC

  • Sherri Kramer, MD, has no affiliations with commercial interests to disclose.
  • Laura Altobelli, MS, has no affiliations with commercial interests to disclose.

Postgraduate Institute for Medicine

  • Jan Hixon, RN, BSN, MS, has no affiliations with commercial interests to disclose.
  • Linda Graham, RN, BSN, has no affiliations with commercial interests to disclose.
  • Trace Hutchison, PharmD, has no affiliations with commercial interests to disclose.
  • Julia Kirkwood, RN, BSN, has no affiliations with commercial interests to disclose.
  • Jan Schultz, RN, MSN, CCMEP, has no affiliations with commercial interests to disclose.

This educational activity may contain discussion of published and/or investigational uses of agents that are not indicated by the FDA. PIM, Robert Michael Educational Institute LLC (RMEI) and ViroPharma Incorporated do not recommend the use of any agent outside of the labeled indications.

The opinions expressed in the educational activity are those of the faculty and do not necessarily represent the views of PIM, RMEI, or ViroPharma Incorporated. Please refer to the official prescribing information for each product for discussion of approved indications, contraindications and warnings.

Participants have an implied responsibility to use the newly acquired information to enhance patient outcomes and their own professional development. The information presented in this activity is not meant to serve as a guideline for patient management. Any procedures, medications or other courses of diagnosis or treatment discussed or suggested in this activity should not be used by clinicians without evaluation of their patient's conditions and possible contraindications on dangers in use, review of any applicable manufacturer's product information and comparison with recommendations of other authorities.

There is no fee for this educational activity.

For questions regarding the content of this activity, contact the accredited provider for this CE activity: jjones@pimed.com. For technical assistance, contact jungsen@rmcom.net.

Hardware/Software requirements include:
• Windows 95, 98se, ME, XP, NT 4.0, 2000   
  - Internet Explorer 4.0+
  - Netscape Navigator 6.2+
  - AOL 8
  - Mozilla Firefox 1.0+

• Macintosh 9.2, OS X 10.1+
  - Safari 1.1+
  - Netscape Navigator 6.2+
  - Internet Explorer 5.2+
  - Mozilla Firefox 1.0+

• Additional requirements
  - Macromedia Flash Player 7
  - Internal/external speakers
  - Broadband connection (DSL/cable) recommended


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