Clostridium difficile – state of the art

Kernaussagen

• Fallzahl und Erkrankungsschwere von Clostridium-difficile-Infektionen (CDI) nehmen in den vergangenen Jahren deutlich zu.

• Das Risiko für eine nosokomiale CDI ist nach den Daten des NRZ für Surveillance nosokomialer Infektionen etwa doppelt so hoch wie für MRSA.

• Wichtigster Risikofaktor ist eine antibiotische Therapie, insbesondere mit Cephalosporinen, Fluorchinolonen und Clindamycin.

• Der rationale Einsatz von Antibiotika – klare Indikation, schmales Erregerspektrum und kurze Therapiedauer – ist für die Primärprävention einer CDI von großer Bedeutung.

• Konsequent umgesetzte krankenhaushygienische Maßnahmen verhindern die Verbreitung von C. difficile.

• Therapie der Wahl sind nach wie vor Metronidazol oder Vancomycin oral, Fidaxomicin scheint eine vielversprechende Alternative zu sein.

• Für schwer verlaufende Fälle besteht in Deutschland eine Meldepflicht.

• Literatur

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