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Clostridium-difficile-Infektionen

Wie gefährlich sind die neuen Stämme?

Clostridium difficile-associated infections

How dangerous are the new strains?

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Zusammenfassung

In den letzten Jahren wurden eine globale Zunahme der Clostridium-difficile-assoziierten Infektionen (CDI) und das Auftreten sog. hypervirulenter Stämme beobachtet, die zu vielen Ausbrüchen geführt haben. Das Auftreten dieser Stämme ging mit einer erhöhten Morbidität und Letalität einher, auch Patienten ohne die zuvor bekannten Risikofaktoren waren betroffen. Diese Stämme haben mittlerweile Deutschland erreicht. Die veränderte Epidemiologie der CDI hat bisher zu keinen Änderungen bei der Diagnostik und Therapie von CDI geführt, macht aber eine Reihe von Präventionsmaßnahmen erforderlich. Hierzu zählen die Erfassung von CDI-Fällen und strikte Hygienemaßnahmen beim Umgang mit betroffenen Patienten. Beim Auftreten schwer verlaufender CDI-Fälle sollte an die hypervirulenten Stämme gedacht und ein kultureller Nachweis angestrebt werden.

Abstract

In recent years, a global increase of Clostridium difficile-associated infections (CDI) and the emergence of new hypervirulent strains causing numerous outbreaks was noticed. The appearance of these strains was accompanied by increased morbidity and mortality, affecting patients previously unknown to be at risk for CDI. Meanwhile, these hypervirulent strains occur in Germany as well. So far, the changing epidemiology of CDI did neither change diagnosis nor therapy of CDI but necessitates a series of preventive measures like the surveillance of CDI and contact precautions while caring for affected patients. If there are complicated or severe cases of CDI, the hypervirulent strains should be suspected and stool culture for isolation of C. difficile should be aimed.

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  1. Institut für Hygiene und Umweltmedizin, Charité - Universitätsmedizin Berlin, Hindenburgdamm 27, 12203, Berlin, Deutschland

    A. Kola

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Kola, A. Clostridium-difficile-Infektionen. Internist 51, 154–160 (2010). https://doi.org/10.1007/s00108-009-2416-9

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  • DOI: https://doi.org/10.1007/s00108-009-2416-9

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