학술논문

Modern Approaches to the Diagnosis and treatment of Clostridioides difficile (C. difficile)-associated Disease in Adults (literature Review and Expert Council Resolution)
Document Type
article
Source
Российский журнал гастроэнтерологии, гепатологии, колопроктологии, Vol 33, Iss 2, Pp 19-33 (2023)
Subject
intestinal microbiota
antibiotics
diarrhea
c. difficile
pseudomembranous colitis
video colonoscopy
fecal transplantation
probiotics
saccharomyces boulardii cncm i-745
Diseases of the digestive system. Gastroenterology
RC799-869
Language
Russian
ISSN
1382-4376
2658-6673
Abstract
Aim: to review the modern approaches to the diagnosis and treatment of C. difficile-associated disease in adults and present the resolution of the Expert Council held on March 25, 2023 in Moscow.General provisions. C. difficile is the most important nosocomial pathogen which spores are also commonly found in the environment. Microbiota impairment, primarily due to the use of antibacterial drugs, is a key stage in the development of C. difficile-associated disease. A search for an infection should be carried out only in patients with diarrhea, and it is advisable to use at least 2 laboratory methods. The drug of choice for first-line treatment is vancomycin. If drug treatment is ineffective or the patient has recurrent clostridial infection, fecal microbiota transplantation should be considered. The probiotic strain Saccharomyces boulardii CNCM I-745 has a direct inhibitory effect on C. difficile toxin A, promotes normalization of the intestinal microbiota composition, and decreases the inflammatory reaction in colonic mucosa colonized with a toxigenic strain of C. difficile.Conclusions. Addition of the probiotic strain Saccharomyces boulardii CNCM I-745 to antibacterial therapy promotes both primary and secondary prevention of C. difficile-associated disease.