Publication details
Doporučený postup diagnostiky a léčby kolitidy vyvolané Clostridium difficile
| Title in English | Diagnosis and therapy of Clostridium difficile infection: Czech national guidelines |
|---|---|
| Authors | |
| Year of publication | 2014 |
| Type | Article in Periodical |
| Magazine / Source | Klinická mikrobiologie a infekční lékařství |
| MU Faculty or unit | |
| Citation | |
| Field | Epidemiology, infectious diseases and clinical immunology |
| Keywords | Clostridium difficile; Fecal transplantation; Fidaxomicin; Metronidazole; Post-antibiotic colitis; Vancomycin |
| Description | Clostridium difficile infection (CDI) is a disease of varying severity. Its manifestations range from mild diarrhea to life-threatening paralytic ileus, painful distension of the large bowel, and sepsis. Another possible manifestation of the disease is recurring colitis that can exhaust the patient. For establishing the diagnosis, the patient's stool should be examined with two or three different microbiological methods (testing for clostridial toxins A and B; testing for clostridial glutamate dehydrogenase, anaerobic culture with specific media, or PCR detection of genes for production of clostridial toxins). An alternative way of assessing the etiology is colonoscopic examination; the disease is confirmed if characteristic patchy pseudomembranes are present in the bowel mucosa. Optimal treatment depends on severity of the disease and on the risk of recurrence. Metronidazole, vancomycin and fidaxomicin are used as basic drugs. Fecal transplantation is effective in recurrent disease. In the hospital setting, patients suffering from CDI should be isolated for the entire duration of diarrhea. Surveillance rules also should be applied, together with early treatment of symptomatic patients and prevention of the spread of the infection. Higher incidence of CDI in a ward implies that the local antibiotic prescription habits should be revised. |