Antibiotic-associated diana, intelligent Clostridium difficiary
DOI:
https://doi.org/10.14739/2310-1210.2018.5.141730Keywords:
diarrhea, Clostridium difficile, intestinal mucosa, diagnosis, treatment, preventionAbstract
Objective: To study antibiotic-associated diarrhea due to Clostridium difficile.
Materials and methods: a retrospective and prospective analysis of literature and studies on C. difficile antibiotic-associated diarrhea was conducted.
Results Despite the concerted efforts to improve the prevention and treatment of C. difficile infection, this infection remains common and serious both in hospitals and among the population. In recent years, germ cell transplantation has emerged as a safe and effective strategy for treating relapsing infections. With further improvement, the microbial transplantation of feces is likely to become the standard of care for periodic infections. Despite the fact that antibiotic therapy and decontamination in health facilities remain important for infection control, effective probiotics and vaccination are likely to become important tools for preventing infection C. difficile in the future. By this time, C. difficile infection continues to be a common and very painful consequence of the use of antibiotics.
Pathogenic C. difficile strains form two protein exotoxins, toxin A and toxin B, which cause damage to the intestinal mucosa and inflammation. The infection can be asymptomatic, cause mild diarrhea or cause severe pseudomembranous colitis. The first step is to stop the use of an antibiotic that causes diarrhea. If diarrhea and colitis are serious or persistent, then the drugs of choice are metronidazole and vancomycin. Clostridium difficile is an anaerobic gram-positive, spore-forming, toxin-producing bacilli that is transmitted to humans through the fecal-oral transmission mechanism. In the United States, C. difficile is the most frequently reported nosocomial pathogen in 2011, with 453,000 cases of C. difficile infection and 29,000 deaths associated with C. Difficile infection.
Conclusions. To date, the incidence of C. difficle-infections has increased, due to the wide and often uncontrolled use of antibiotics.
It should be noted that antibiotic-associated diarrheas due to C. difficile occupy one of the first places in the structure of morbidity and mortality among infectious diarrheas, representing a serious and antimicrobial problem of therapy in the conditions of the in-patient and among the population.
CDI has become an increasingly common infection and has shown an increase in severity over the past few years.
References
Bogun, L. V. (2006) Antibiotikoassociirovannaya diareya [Antibiotic-associated diarrhea]. Klinicheskaya antibiotikoterapiya, 3, 40–43. [in Russian].
Korneyeva, O. N., & Ivashkin, V. T (2007) Antibiotikoassociirovannyj kolit: patomorfologiya, klinika, lechenie [Antibiotic-associated colitis: pathomorphology, clinical presentation, treatment]. Rossijskij zhurnal gastroe'nterologii, gepatologii, koloproktologii, 3, 65–70. [in Russian].
Malov, V. A. (2002) Antibiotikoassociirovannye diarei [Antibiotic-associated diarrhea]. Klinicheskaya mikrobiologiya i antimikrobnaya khimioterapiya, 4(1), 185–197. [in Russian].
Shul'pekova, Yu. O. (2007) Antibiotikoassociirovannaya diareya [Antibiotic-associated diarrhea]. Russkij medicinskij zhurnal, 6, 467–473. [in Russian].
Malov, V. A. (2000) Antibiotiko-associirovannye porazheniya kishechnika [Antibiotic-associated intestinal lesions]. Vrach, 10, 16–19. [in Russian].
Anastasij, N. A., & Dudar' D. N. (2011) Antibiotikoassociirovannaya diareya: problemy diagnostiki [Antibiotic-associated diarrhea: diagnostic problems]. Klinichna imunolohiia, 2(41), 56–58. [in Russian].
Shifrin, O. S., & Androsova, L. N. (2003) Antibiotikoassociirovannaya diareya: novye vozmozhnosti lecheniya i profilaktiki [Antibiotic-associated diarrhea: new opportunities for treatment and prevention]. Rossijskij zhurnal gastroe'nterologii, gepatologii i koloproktologii, 5, 82–86. [in Russian].
Petruk, M. N., & Neshitov, S. P. (2009) Psevdomembranoznyiy kolit [Pseudomembranous colitis]. Khirurgiya. Zhurnal im. N.I. Pirogova, 4, 55–60. [in Russian].
Kopcha, V. S. (2007) Antybiotykoasotsiiovanyi dysbakterioz kyshechnyku: zahalna kharakterystyka ta mozhlyvosti suchasnoho konservatyvnoho likuvannia [Antibiotic-associated intestinal dysbiosis: general characteristics and possibilities of modern conservative treatment]. Infektsiini khvoroby, 3, 87–96. [in Ukrainian].
Bahrii, M. M. (2012) Psevdomembranoznyi kolit: kliniko-morfolohichnyi analiz fatal'noho vypadku [Pseudomembranous colitis: clinical and morphological analysis of the fatal case]. Arkhiv klinichnoi medytsyny, 2(18), 95–99. [in Ukrainian].
Tumak, I. M (2010) Diareia i psevdomembranoznyi kolit, zumovleni Clostridium difficile [Diarrhea and pseudomembranous colitis are due Clostridium difficile]. Medytsyna svitu, 6, 52–60. [in Ukrainian].
Hall, I. (1935). Intestinal flora in newborn infants with a description of a new pathogenic anaerobe. Bacillus difficilis. Am J Dis Child. 49, 390–393. doi: 10.1001/archpedi.1935.01970020105010.
Lessa, F., Mu, Y., Bamberg, W., Beldavs, Z., Dumyati, G., & Dunn, J. et al. (2015). Burden of Clostridium difficile Infection in the United States. New England Journal Of Medicine, 372(9), 825–834. doi: 10.1056/NEJMoa1408913.
Lofgren, E., Cole, S., Weber, D., Anderson, D., & Moehring, R. (2014). Hospital-Acquired Clostridium difficile Infections. Epidemiology, 25(4), 570–575. doi: 10.1097/EDE.0000000000000119.
Rupnik, M. (2007). Is Clostridium difficile-associated infection a potentially zoonotic and foodborne disease? Clinical Microbiology And Infection, 13(5), 457–459. doi: 10.1111/j.1469-0691.2007.01687.x
Jangi, S., & Lamont, J. (2010). Asymptomatic Colonization by Clostridium difficile in Infants: Implications for Disease in Later Life. Journal of Pediatric Gastroenterology and Nutrition, 51(1), 2–7. doi: 10.1097/MPG.0b013e3181d29767.
Viscidi, R., Laughon, B., Yolken, R., Bo-Linn, P., Moench, T., Ryder, R., & Bartlett, J. (1983). Serum Antibody Response to Toxins A and B of Clostridium difficile. Journal Of Infectious Diseases, 148(1), 93–100. doi: 10.1093/infdis/148.1.93.
Rousseau, C., Poilane, I., De Pontual, L., Maherault, A., Le Monnier, A., & Collignon, A. (2012). Clostridium difficile Carriage in Healthy Infants in the Community: A Potential Reservoir for Pathogenic Strains. Clinical Infectious Diseases, 55(9), 1209–1215. doi: 10.1093/cid/cis637.
Eglow, R., Pothoulakis, C., Itzkowitz, S., Israel, E., O'Keane, C., Gong, D., et al. (1992). Diminished Clostridium difficile toxin A sensitivity in newborn rabbit ileum is associated with decreased toxin A receptor. Journal of Clinical Investigation, 90(3), 822–829. doi: 10.1172/JCI115957.
O'Connor, J., Johnson, S., & Gerding, D. (2009). Clostridium difficile Infection Caused by the Epidemic BI/NAP1/027 Strain. Gastroenterology, 136(6), 1913–1924. doi: 10.1053/j.gastro.2009.02.073.
McDonald, L., Killgore, G., Thompson, A., Owens, R., Kazakova, S., Sambol, S., et al. (2005). An Epidemic, Toxin Gene–Variant Strain of Clostridium difficile. New England Journal of Medicine, 353(23), 2433–2441. doi: 10.1056/NEJMoa051590.
Akerlund, T., Persson, I., Unemo, M., Noren, T., Svenungsson, B., Wullt, M., & Burman, L. (2008). Increased Sporulation Rate of Epidemic Clostridium difficile Type 027/NAP1. Journal of Clinical Microbiology, 46(4), 1530–1533. doi: 10.1128/JCM.01964-07.
Loo, V., Poirier, L., Miller, M., Oughton, M., Libman, M., Michaud, S., et al. (2005). A Predominantly Clonal Multi-Institutional Outbreak of Clostridium difficile – Associated Diarrhea with High Morbidity and Mortality. New England Journal of Medicine, 353(23), 2442–2449. doi: 10.1056/NEJMoa051639.
Warny, M., Pepin, J., Fang, A., Killgore, G., Thompson, A., & Brazier, J. et al. (2005). Toxin production by an emerging strain of Clostridium difficile associated with outbreaks of severe disease in North America and Europe. The Lancet, 366(9491), 1079–1084. doi: 10.1016/S0140-6736(05)67420-X.
McFarland, L., Elmer, G. W., & Surawicz, C. M. (2002). Breaking the cycle: treatment strategies for 163 cases of recurrent Clostridium difficile disease. The American Journal of Gastroenterology, 97(7), 1769–1775. doi: 10.1111/j.1572-0241.2002.05839.x.
Ghose, C., Kalsy, A., Sheikh, A., Rollenhagen, J., John, M., Young, J. et al. (2007). Transcutaneous Immunization with Clostridium difficile Toxoid A Induces Systemic and Mucosal Immune Responses and Toxin A-Neutralizing Antibodies in Mice. Infection And Immunity, 75(6), 2826–2832. doi: 10.1128/IAI.00127-07.
Chitnis, A. S., Holzbauer, S. M., Belflower, R. M., Winston, L. G., Bamberg, W. M., Lyons, C., et al. (2013). Epidemiology of community-associated Clostridium difficile infection, 2009 through 2011. JAMA Intern Med, 173(14), 1359–1367. doi: 10.1001/jamainternmed.2013.7056.
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