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[艰难梭菌感染的诊断、治疗和预防跨学会指南]

[Intersociety guidelines for diagnosis, treatment and prevention of Clostridioides difficile infections].

作者信息

Barcán Laura, Ducatenzeiler Laura, Bangher María Del Carmen, Barcelona Laura, Cornistein Wanda, Daciuk Lucía, De Paula Juan, Desse Jaier, Dictar Miguel, Fernández-Canigia Liliana, Nacinovich Fancisco, Scapellato Pablo, Martínez Jorge Víctor

机构信息

Hospital Italiano de Buenos Aires, Buenos Aires, Argentina. E-mail:

Sociedad Argentina de Infectología (SADI).

出版信息

Medicina (B Aires). 2020;80 Suppl 1:1-32.

Abstract

Clostridioides difficile infections (CDI) are among the leading causes of health care-associated infections. The epidemiology of CDI has undergone major changes in the last decade, showing an increase in incidence, severity, and rate of relapse. These guidelines were developed by specialists from four scientific societies: Sociedad Argentina de Infectología (SADI), Sociedad Argentina de Gastroenterología (SAGE), Sociedad Argentina de Bacteriología, Micología y Parasitología Clínicas (SADEBAC) and Asociación de Enfermeras en Control de Infecciones (ADECI). The objective of these intersociety guidelines is to provide national recommendations on CDI diagnosis, treatment and prevention. The methodology used involved the systematic review of the bibliography available up to December 2018, which was performed by six groups formed ad hoc: Epidemiology, Diagnosis, Treatment, Fecal Microbiota Transplantation, Special Populations, and Infection Control. The conclusions were presented and discussed in meetings held by each individual group and plenary meetings. In this document, updated diagnosis algorithms, therapeutic options (including fecal microbiota transplant) for immunocompetent and immunocompromised patients are presented, as well as strategies for the control of C. difficile infection.

摘要

艰难梭菌感染(CDI)是医疗保健相关感染的主要原因之一。在过去十年中,CDI的流行病学发生了重大变化,发病率、严重程度和复发率均有所上升。这些指南由四个科学协会的专家制定:阿根廷感染病学会(SADI)、阿根廷胃肠病学会(SAGE)、阿根廷临床细菌学、真菌学和寄生虫学学会(SADEBAC)以及感染控制护士协会(ADECI)。这些跨学会指南的目的是提供关于CDI诊断、治疗和预防的国家建议。所采用的方法包括对截至2018年12月的现有文献进行系统综述,这由六个特设小组进行:流行病学、诊断、治疗、粪便微生物群移植、特殊人群和感染控制。各小组会议和全体会议对结论进行了展示和讨论。本文档介绍了更新后的诊断算法、针对免疫功能正常和免疫功能低下患者的治疗选择(包括粪便微生物群移植),以及艰难梭菌感染的控制策略。

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