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[医院获得性胃肠道感染与艰难梭菌]

[Nosocomial gastrointestinal infections and Clostridioides difficile].

作者信息

Weirauch Tobias, Vehreschild Maria J G T

出版信息

Dtsch Med Wochenschr. 2025 Feb;150(4):149-156. doi: 10.1055/a-2303-3321. Epub 2025 Jan 29.

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.

摘要

德国2022年的监测数据显示,住院患者的医院感染患病率为5.2%。艰难梭菌感染(CDI)是医院感染性腹泻最常见的病因。它们通常由抗生素暴露以及随后肠道微生物群的变化引起。临床表现从无症状定植到中度腹泻,再到严重的伪膜性结肠炎。根据当前德国胃肠道感染指南,非达霉素是CDI的首选治疗方案,特别是对于复发风险高的患者或已经复发的患者。万古霉素也可作为CDI初始治疗的替代药物。粪便微生物群移植被认为是多次复发患者的一种治疗方法。

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