Mayo Clinic, Jacksonville, FL, USA.
J Prim Care Community Health. 2024 Jan-Dec;15:21501319241249645. doi: 10.1177/21501319241249645.
Clostridioides difficile infection (CDI) is one of the most common and severe nosocomial infections worldwide. It can also affect healthy individuals in the community. The incidence of CDI has been on the rise globally for the past decade, necessitating a proactive approach to combat its spread; new strategies are being developed to enhance diagnostic accuracy and optimize treatment outcomes. Implementing the 2-step testing has increased diagnostic specificity, reducing the usage of CD-specific antibiotics with no concomitant increase in surgical complication rates. In 2021, the Infectious Diseases Society of America/Society for Healthcare Epidemiology of America (IDSA/SHEA) shifted its preference for initial treatment to fidaxomicin over vancomycin and metronidazole due to its lower recurrence rate. It also prioritized fidaxomicin for the treatment of recurrent CDI. There are new developments on the frontiers of fecal microbiota therapies, with RBX2660 and SER-109 approved recently by the FDA for prevention, with other microbiome-based therapies in various development and clinical trials. This review offers providers an updated and practical guide for CDI management.
艰难梭菌感染（CDI）是全球最常见和最严重的医院获得性感染之一。它也可能影响社区中的健康个体。在过去的十年中，CDI 的发病率在全球呈上升趋势，因此需要采取积极主动的方法来控制其传播；正在开发新的策略来提高诊断准确性并优化治疗结果。实施两步检测提高了诊断的特异性，减少了无手术并发症发生率增加的情况下使用 CD 特异性抗生素。2021 年，美国传染病学会/美国医疗保健流行病学学会（IDSA/SHEA）由于复发率较低，将初始治疗的首选药物从万古霉素和甲硝唑改为非达霉素。它还将非达霉素作为复发性 CDI 的治疗药物。粪便微生物群疗法领域有新的进展，RBX2660 和 SER-109 最近被 FDA 批准用于预防，其他基于微生物组的疗法也处于不同的开发和临床试验阶段。本综述为提供者提供了 CDI 管理的最新实用指南。
