Pseudomembranous colitis: risk factors, clinical picture, treatment
- Authors: Potapova T.V1,2, Ermolenko K.D3,4, Lioznov D.A1
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Affiliations:
- First St. Petersburg State Medical University n.a. I.P. Pavlov
- Clinical Infectious Diseases Hospital n.a. S.P. Botkin
- Children's Scientific and Clinical Center of Infectious Diseases of the Federal Medical Biological Agency
- SRI of Epidemiology and Microbiology n.a. Pasteur
- Issue: No 2 (2018)
- Pages: 64-68
- Section: Articles
- URL: https://journals.eco-vector.com/2073-4034/article/view/294576
- ID: 294576
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Abstract
Purpose of the study. Analysis of modern aspects of the clinical and laboratory course of pseudomembranous colitis (PMC), and the determination of the optimal treatment regimens for this disease. Material and Methods. Using continuous sampling method, 122 patients with PMC aged 18 to 96 years, including 35 (28.7%) men and 87 (71.3%) women, were enrolled in study. Results. During an endoscopic examination, a typical macroscopic picture was revealed in all patients: whitish-yellowish pseudomembranous plaques were found throughout the distal sections of the mucous membrane of the colon. Development of PMC was most often preceded by courses of antibacterial drugs from groups of fluoroquinolones and cephalosporins. As etiotropic drugs in the complex therapy of PMC, metronidazole and vancomycin were used. Conclusions. PMC is a variant of the severe course of antibiotic-associated diarrhea (AAD). For effective treatment of PMC, complex therapy is needed, including etiotropic agents, probiotic drugs and pathogenetic agents. Colonoscopy in patients with AAD can significantly increase the frequency of detection of severe forms of this condition and timely adjust the drug therapy.
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About the authors
T. V Potapova
First St. Petersburg State Medical University n.a. I.P. Pavlov; Clinical Infectious Diseases Hospital n.a. S.P. Botkin
K. D Ermolenko
Children's Scientific and Clinical Center of Infectious Diseases of the Federal Medical Biological Agency; SRI of Epidemiology and Microbiology n.a. Pasteur
Email: ermolenko.kd@yandex.ru
Postgraduate Student; Researcher at the Department of Pathogen Identification
D. A Lioznov
First St. Petersburg State Medical University n.a. I.P. Pavlov
References
- Elseviers M.M., Van Camp Y., Nayaert S., Duré K., Annemans L., Tanghe A., Vermeersch S. Prevalence and management of antibiotic associated diarrhea in general hospitals. BMC infect. Dis. 2015;15(1):129.
- Gerding D.N., Lessa F.C. The epidemiology of Clostridium difficile infection inside and outside health care institutions. infect. Dis. Clin. 2015;29(1):37-50.
- Gravel D., Miller M., Simor A., et al. Health care-associated Clostridium difficile infection in adults admitted to acute care hospitals in Canada: A Canadian nosocomial infection surveillance program study. Clin. infect. Dis. 2009; 48:568-76.
- Захарова Н.В., Филь Т.С. Псевдомембранозный колит: патогенез, профилактика, лечение. Экспериментальная и клиническая гастроэнтерология. 2013;12.
- Vecchio A.L., Zacur G.M. Clostridium difficile infection: an update on epidemiology, risk factors, and therapeutic options. Curr. Opin. Gastroenterol. 2012;28(1):1-9.
- Janarthanan S., Ditah I., Adler D.G., Ehrinpreis M.N. Clostridium difficile-associated diarrhea and proton pump inhibitor therapy: a meta-analysis. Am. J. Gastroenterol. 2012;107(7):1001.
- Knecht H., Neulinger S.C., Heinsen F.A., et al. Effects of β-lactam antibiotics and fluoroquinolones on human gut microbiota in relation to Clostridium difficile associated diarrhea. PLoS One. 2014;9(2):e89417.
- Kelly C.P Can we identify patients at high risk of recurrent Clostridium difficile infection? Clin. Microbiol. infect. 2012;18(6):21-7.
- Ермоленко К.Д., Гончар Н.В., Ермоленко Е.И. и др. Нарушение микробиоценоза кишечника как фактор формирования постинфекционной патологии органов пищеварения у детей после вирусных кишечных инфекций. Эксперим. и клин. гастроэнтерол. 2017;131(1):53-7.
- Surawicz C.M., Brandt L.J., Binion D.G., Ananthakrishnan A.N., Curry S.R., Gilligan P.H., McFarland L.V., Mellow M., Zuckerbraun B.S. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am. J. Gastroenterol. 2013;108(4):478.
- Khanna S., Pardi D.S., Aronson S.L., Kammer P.P., Orenstein R., St Sauver J.L., Harmsen W.S., Zinsmeister A.R. The epidemiology of community-acquired Clostridium difficile infection: a population-based study. Am. J. Gastroenterol. 2012;107(1):89.
- Plummer S., Weaver M.A., Harris J.C., Dee P., Hunter J. Clostridium difficile pilot study: effects of probiotic supplementation on the incidence of C. difficile diarrhea. int. Microbiol. 2004; 7(1):59-62.
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