PSEUDOMEMBRANOUS COLITIS: DIAGNOSIS, TREATMENT AND PREVENTION
Abstract
In recent years, Clostridium difficile has become one of the most common and aggressive nosocomial pathogens. The toxigenic strain of C. difficile is the etiological agent of pseudomembranous colitis. This disease leads to the development of dangerous complications without proper therapy. To prevent the C. difficile infection, optimization of in-hospital antibiotics usage and strict compliance with principles of infection control are required. The review of literature presents modern approaches to diagnosis, treatment and prevention of infections, caused by C. difficile.
About the Author
T. V. ChyornenkayaRussian Federation
References
1. Four-fold difference in antibiotic consumption across the European Region — new WHO report. Available at: http://www.euro.who.int/ru/health-topics/disease-prevention/antimicrobial-resistance/news/news/2014/03/new-data-on-antibiotic-use-in-european-region (Accessed March 1, 2016)
2. Analiz rynka antibiotikov v Rossii v 2007–2011 gg, prognoz na 2012–2016 gg. [Market analysis of antibiotics in Russia in 2007–2011, the forecast for 2012–2016]. Available at: http://marketing.rbc.ru/research/562949983900801.shtml (Accessed March 1, 2016) (In Russian).
3. Ashiru-Oredope D., Sharland M., Charani E., et al. Improving the quality of antibiotic prescribing in the NHS by developing a new Antimicrobial Stewardship Programme: Start Smart – Then Focus. J Antimicrob Chemother. 2012; 67 Suppl 1: i51–63.
4. Coutsoftides T., Benjamin S. P., Fazio V W. Pseudomembranous enterocolitis in adults. Ann Surg. 1979; 189 (4): 493–495.
5. Hummel R.P., Altemeier W.A., Hill E.O. Iatrogenic staphylococcal enterocolitis. Ann Surg. 1964; 160: 551–560.
6. Keeffe E.B., Katon R.M., Chan T.T., et al. Pseudomembranous enterocolitis. Resurgence related to newer antibiotic therapy. West J Med. 1974; 121 (6): 462–472.
7. Chang T.W., Bartlett J.G., Gorbach S.L., Onderdonk A.B. Clindamycininduced enterocolitis in hamsters as a model of pseudomembranous colitis in patients. Infect Immun. 1978; 20 (2): 526–529.
8. George R.H., Symonds J.M., Dimock F., et al. Identification of Clostridium difficile as a cause of pseudomembranous colitis. BMJ. 1978; 1: 695.
9. Bergey’s manual of systematic bacteriology. Williams&Wilkins, 1986. Vol. 2. 1165–1167.
10. Aronsson B., Möllby R., Nord C.E. Antimicrobial agents and Clostridium difficile in acute enteric disease: epidemiological data from Sweden, 1980–1982. J Infect Dis. 1985; 151 (3): 476–481.
11. Alfa M.J., Du T., Beda G. Survey of incidence of Clostridium difficile infection in Canadian hospitals and diagnostic approaches. J Clin Microbiol. 1998; 36 (7): 2076–2080.
12. Steele J., Chen K., Sun X., et al. Systemic dissemination of Clostridium difficile toxins A and B is associated with severe, fatal disease in animal models. J Infect Dis. 2012; 205: 384–391.
13. Gonçalves C., Decré D., Barbut F., et al. Prevalence and characterization of a binary toxin (actin-specific ADP-ribosyltransferase) from Clostridium difficile. J Clin Microbiol. 2004; 42 (5): 1933–1939.
14. Schwan C., Stecher B., Tzivelekidis T., et al. Clostridium difficile toxin CDT induces formation of microtubule-based protrusions and increases adherence of bacteria. PLoS Pathog. 2009; 5 (10): e1000626.
15. Lanis J.M., Barua S., Ballard J.D. Variations in TcdB activity and the hypervirulence of emerging strains of Clostridium difficile. PLoS Pathog. 2010; 6 (8): e1001061.
16. Hensgens M.P., Goorhuis A., Dekkers O.M., Kuijper E.J. Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. J Antimicrob Chemother. 2012; 67 (3): 742–748.
17. Garey K.W., Dao-Tran T.K., Jiang Z.D., et al. A clinical risk index for Clostridium difficile infection in hospitalised patients receiving broadspectrum antibiotics. J Hosp Infect. 2008; 70 (2): 142–147.
18. Garey K.W., Sethi S., Yadav Y., et al. Meta-analysis to assess risk factors for recurrent Clostridium diffi cile infection. J Hosp Infect. 2008; 70 (4): 298–304.
19. Lucado J., Gould C., Elixhauser A. Clostridium difficile Infections (CDI) in Hospital Stays, 2009. Available at: http: //www.hcup-us.ahrq.gov/reports/statbriefs/sb124.pdf (Accessed March 1, 2016)
20. Burckhardt F., Friedrich A., Beier D., Eckmanns T. Clostridium difficile surveillance trends, Saxony, Germany. Emerg Infect Dis. 2008; 14 (4): 691–692.
21. Magill S.S., Edwards J.R., Bamberg W., et al. Multistate point-prevalence survey of health care-associated infections. N Engl J Med. 2014; 370 (13): 1198–1208.
22. Cohen S.H., Gerding D.N., Johnson S., et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infect Control Hosp Epidemiol. 2010; 31 (5): 431–455.
23. Bobo L. D., Dubberke E. R., Kollef M. Clostridium difficile in the ICU. Chest. 2011; 140 (6): 1643–1653.
24. Wenisch J.M., Schmid D., Kuo H.W., et al. Hospital-acquired Clostridium difficile infection: determinants for severe disease. Eur J Clin Microbiol Infect Dis. 2012; 31 (8): 1923–1930.
25. Bauer M.P., Notermans D.W., van Benthem B.H., et al. Clostridium difficile infection in Europe: a hospital-based survey. Lancet. 2011; 377: 63–73.
26. Berdichevski T., Keller N., Rahav G., et al. The impact of pseudo - membrane formation on the outcome of Clostridium difficile associated disease. Infection. 2013; 41 (5): 969–977.
27. Lessa F.C., Mu Y., Bamberg W.M., et al. Burden of Clostridium difficile Infection in the United States. N Engl J Med. 2015; 372: 825–834.
28. Lamontagne F., Labbe A.C., Haeck O., et al. Impact of emergency colectomy on survival of patients with fulminant Clostridium difficile colitis during an epidemic caused by a hypervirulent strain. Ann Surg. 2007; 245 (2): 267–272.
29. Bartlett J.G., Gerding D.N. Clinical recognition and diagnosis of Clostridium difficile infection. Clin Infect Dis. 2008; 46 Suppl 1: S 12–18.
30. Crobach M.J., Dekkers O.M., Wilcox M.H., Kuijper E.J. European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI). Clin Microbiol Infect. 2009; 15 (12): 1053–1066.
31. Surawicz C.M., Brandt L.J., Binion D.G., et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013; 108 (4): 478–498.
32. Debast S.B., Bauer M.P., Kuijper E.J. European Society of Clinical Microbiology and Infectious Diseases: update of the treatment guidance document for Clostridium difficile infection. Available at: http://onlinelibrary.wiley. com/doi/10.1111/1469-0691.12418/full (Accessed March 1, 2016)
33. A practical guidance document for the laboratory detection of toxigenic Clostridium difficile. Washington, DC: American Society for Microbiology, Sept. 21, 2010. Available at: http://www.asm.org/images/pdf/Clinical/clostridiumdifficile9-21.pdf. (Accessed March 1, 2016)
34. Zar F.A., Bakkanagari S.R., Moorthi K.M., Davis M.B. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis. 2007. 45 (3): 302–307.
35. Kopterides P., Papageorgiou C., Antoniadou A., et al. Failure of tigecycline to treat severe Clostridium difficile infection. Anaesth Intensive Care. 2010; 38 (4): 755–758.
36. Kleger A., Schnell J., Essig A., et al. Fecal transplant in refractory Clostridium difficile colitis. Dtsch Arztebl Int. 2013; 110 (7): 108–115.
37. Petrof E.O., Khoruts A. From stool transplants to next-generation microbiota therapeutics. Gastroenterology. 2014; 146 (6): 1573–1582.
38. Freeman J., Baines S.D., Todhunter S.L., et al. Nitazoxanide is active against Clostridium difficile strains with reduced susceptibility to metronidazole. J Antimicrob Chemother. 2011; 66 (6): 1407–1408.
39. Carman R.J., Boone J.H., Grover H., et al. In vivo selection of rifamycin- resistant Clostridium difficile during rifaximin therapy. Antimicrob Agents Chemother. 2012; 56 (11): 6019–6020.
40. Mattila E., Arkkila P., Mattila P.S., et al. Rifaximin in the treatment of recurrent Clostridium difficile infection. Aliment Pharmacol Ther. 2013; 37 (1): 122–128.
41. Allen S.J., Wareham K., Wang D., et al. Lactobacilli and bifidobacteria in the prevention of antibiotic-associated diarrhoea and Clostridium difficilediarrhoea in older inpatients (PLACIDE): a randomised, doubleblind, placebo-controlled, multicentre trial. Lancet. 2013; 382: 1249– 1257.
42. Rainkie D., Kolber M.R. Probiotics for the prevention of Clostridium difficile. Can Fam Physician. 2013; 59 (9): 957.
43. Issa I., Moucari R. Probiotics for antibiotic-associated diarrhea: do we have a verdict? World J Gastroenterol. 2014; 20 (47): 17788–17795.
44. Flatley E.A., Wilde A.M., Nailor M.D. Saccharomyces boulardii for the prevention of hospital onset Clostridium difficile infection. J Gastrointestin Liver Dis. 2015; 24 (1): 21–24.
45. Goldenberg J.Z., Ma S.S., Saxton J.D., et al. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Syst Rev. 2013; 5: CD006095. doi: 10.1002/14651858. CD006095.
46. Dubberke E.R., Reske K.A., Noble-Wang J., et al. Prevalence of Clostridium difficile environmental contamination and strain variability in multiple health care facilities. Am J Infect Control. 2007; 35 (5): 315–318.
47. Walker N., Gupta R., Cheesbrough J. Blood pressure cuffs: friend or foe? J Hosp Infect. 2006; 63 (2): 167–169.
48. Wilcox M.H., Shetty N., Fawley W.N., et al. Changing epidemiology of Clostridium difficile infection following the introduction of a national ribotyping-based surveillance scheme in England. Clin Infect Dis. 2012; 55 (8): 1056–1063.
49. Jen M.H., Saxena S., Bottle A., et al. Assessment of administrative data for evaluating the shifting acquisition of Clostridium difficile infection in England. J Hosp Infect. 2012; 80 (3): 229–237.
50. Boyce J.M., Ligi C., Kohan C., et al. Lack of association between the increased incidence of Clostridium difficile-associated disease and the increasing use of alcohol-based hand rubs. Infect Control Hosp Epidemiol. 2006; 27 (5): 479–483.
51. M.B. Bogdanov, T.V. Chernen’kaya. Algoritmy i organizatsiya antibiotikoterapii: rukovodstvo dlya vrachey [Algorithms and organization of antibiotic therapy]. Moscow: Vidar Publ., 2004. 219 p. (In Russian).
52. Nuila F., Cadle R.M., Logan N., et al. Antibiotic stewardship and Clostridium difficile-associated disease. Infect Control Hosp Epidemiol. 2008; 29 (11): 1096–1097.
Review
For citations:
Chyornenkaya T.V. PSEUDOMEMBRANOUS COLITIS: DIAGNOSIS, TREATMENT AND PREVENTION. Russian Sklifosovsky Journal "Emergency Medical Care". 2016;(1):33-39. (In Russ.)