• Clostridium difficile infection in children and adults as a important reason of antibiotic associated diarrhea
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Clostridium difficile infection in children and adults as a important reason of antibiotic associated diarrhea

Modern Pediatrics.Ukraine.2020.3(107):59-66; doi 10.15574/SP.2020.107.59
Romankevych I. V.
Shupyk National Medical Academy of Postgraduate Education, Kуiv, Ukraine
Dr. Rodger Laboratory Clinic, Kyiv, Ukraine

For citation: Romankevych IV. (2020). Clostridium difficile infection in children and adults as a important reason of antibiotic associated diarrhea. Modern Pediatrics. Ukraine. 3(107): 5966; doi 10.15574/SP.2020.107.59
Article received: Nov 03, 2019. Accepted for publication: Apr 15, 2020.

Antibiotic-associated diarrhea is a major medical problem worldwide. C. difficile is the most dangerous cause, the overgrowingn of which with the enteropathogenic toxin release is observed as a result of depletion of an intestinal microbiota, after antibiotics using. Despite an active researching of C. difficile (CDI) infection in Western countries, it diagnostics and treatment in Ukraine are underdeveloped.
The aim of this article is to familiarize a wide range of physicians of various specialties with the specifics of the epidemiology, clinic, diagnosis and treatment of CDI as the most dangerous form of antibiotic-associated diarrhea.
The article highlights the risk factors for the development of CDI, the main aspects of the clinical picture, the two- and three-stage diagnostic algorithms and peculiarities of infection treatment and its relapse in adults and children.
No conflict of interest was declared by the author.
Key words: C. difficile, toxin, diarrhea, NAAT, ELISA for GDH antigen detection, Vancomycin, Fidoximycin.

REFERENCES

1. Burnham CA, Carroll KC. (2013, Jul). Diagnosis of Clostridium difficile infection: an ongoing conundrum for clinicians and for clinical laboratories. Clin Microbiol Rev.26(3): 604–30. https://doi.org/10.1128/CMR.00016-13; PMid:23824374 PMCid:PMC3719497

2. Crobach MJT, Planche Т, Eckert С, Barbut F et al. (2016, Aug). European Society of Clinical Microbiology and Infectious Diseases: update of the diagnostic guidance document for Clostridium difficile infection. Clinical Microbiology and Infection. 22;4(1): 63–81. https://doi.org/10.1016/j.cmi.2016.03.010; PMid:27460910

3. Delmee M, Verellen G, Avesani V, Francois G. (1988). Clostridium difficile in neonates: serogrouping and epidemiology. Eur J Pediatr. 147: 36–40. https://doi.org/10.1007/BF00442608; PMid:3338476

4. Gonzalez-Del Vecchio M, Alvarez-Uria A, Marin M. (2016). Clinical significance of Clostridium difficile in children less than 2 years old: a case-control study. Pediatr Infect Dis J.35: 281–285. https://doi.org/10.1097/INF.0000000000001008; PMid:26650114

5. Khanna S, Baddour LM, Huskins WC et al. (2013). The epidemiology of Clostridium difficile infection in children: a population-based study. Clin Infect Dis.56: 1401–1406. https://doi.org/10.1093/cid/cit075; PMid:23408679 PMCid:PMC3693491

6. Lubbert C, Endres John, Lutz von Muller. (2014, Oct). Clostridium Difficile Infection Guideline-Based Diagnosis and Treatment. Dtsch Arztebl Int. 111(43): 723–731. https://doi.org/10.3238/arztebl.2014.0723; PMid:25404529 PMCid:PMC4238315

7. McDonald L Clifford, Dale N Gerding, Stuart Johnson, Johan S Bakken et al. (1 April 2018). Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clinical Infectious Diseases. 66;7: e10e48. https://doi.org/10.1093/cid/cix1085; PMid:29462280 PMCid:PMC6018983

8. Nagy Elisabeth. (2018). What do we know about the diagnostics, treatment and epidemiology of Clostridioides(Clostridium) difficile infection in Europe? Journal of Infection and Chemotherapy.24;3: 164–170. https://doi.org/10.1016/j.jiac.2017.12.003; PMid:29289484

9. Rea MC, O'Sullivan O, Shanahan F, O'Toole P.W. et al. (2012). Clostridium difficile carriage in elderly subjects and associated changes in the intestinal microbiota. J Clin Microbiol. 50: 867–875. https://doi.org/10.1128/JCM.05176-11; PMid:22162545 PMCid:PMC3295116

10. Valentini D, Vittucci AC, Grandin A et al. (2013). Coinfection in acute gastroenteritis predicts a more severe clinical course in children. Eur J Clin Microbiol Infect Dis.32: 909–915. https://doi.org/10.1007/s10096-013-1825-9; PMid:23370970

11. What is C. diff? https://www.cdc.gov

12. Wilcox MH. (2012, Dec). Overcoming barriers to effective recognition and diagnosis of Clostridium difficile infection. Clin Microbiol Infect.18;6: 13020. https://doi.org/10.1111/1469-0691.12057; PMid:23121550.

13. Zhong Peng, Lifen Ling, Charles W, Chunhui Li et al. (2018). Advances in the diagnosis and treatment of Clostridium difficile infections. Emerging Microbes & Infections. 7;1: 1–13. https://doi.org/10.1038/s41426-017-0019-4; PMid:29434201 PMCid:PMC5837143