Im klinischen Alltag bedingt der Einsatz von Antibiotika häufig eine Veränderung des
Mikrobioms, welche den Ausbruch einer Clostridioides-difficile-Infektion (CDI) begünstigt.
Diese Arbeit gibt einen kompakten Überblick über die Epidemiologie, Pathophysiologie,
Diagnostik und Therapie der CDI. Daneben stellen wir die wesentlichen Neuerungen bezüglich
der CDI in der überarbeiteten S2k-Leitlinie Gastrointestinale Infektionen vor.
Abstract
German surveillance data from 2022 reported a prevalence of nosocomial infections
among hospitalized patients of 5,2%. Clostridioides-difficile-infections (CDI) are
the most frequent cause of nosocomial diarrhea. They are usually caused by antibiotic
exposure and the subsequent changes in the gut microbiota. Clinical manifestation
ranges from asymptomatic colonization over moderate diarrhea to severe pseudomembranous
colitis. According to the current German Gastrointestinal Infection Guidelines, fidaxomicin
is the preferred treatment option for CDI, especially in patients at high risk of
recurrence or those already suffering from recurrence. Vancomycin can also be used
as an alternative for initial CDI treatment. Fecal microbiota transplantation is considered
a treatment approach for patients with multiple recurrences.
Schlüsselwörter
Diarrhö - nosokomial - Clostridioides difficile - Infektion - Mikrobiotatransfer
- fäkal
Keywords
diarrhea - nosocomial - Clostridioides difficile - infection - microbiota transplantation
- fecal