Author/Editor		Baklan, Zvonko; Rejc-Marko, Jana; Rupnik, Maja; Orešič, Nadja
Title		Okužbe s Clostridium difficile: zapleti, zdravljenje in diagnostika
Translated title		Clostridium difficile associated disease: a new characteristics and therapy
Type		članek
Source		In: Rejc-Marko J, Ekart-Koren K, Veingerl B, et al. Okužbe v torakalni kirurgiji in pristop k zdravljenju. ,
Publication year		2007
Volume		str. 157-69
Language		slo
Abstract		Clostridium difficile associated disease is the most common case of antibiotic associated diarrhea. The disease can range from uncomplicated diarrhea to life treatening colitis. There has been an important change in the last few years - we noted increased incidence and severity of this diseasewith enhanced mortality. A lot of factors probably contributed to this. One of them, in addition with host and environmental factors, was the emergence of a new strain of C. difficile with enhanced virulence properties. Current treatment guidelines recommend treatment with metronidazole as a first line and vancomycin as a second line agent. Earlier reports have suggested that recommended treatment cure - 90 % of patients. In recent years, the rate of response to treatment has appeared to be much lower and other treatment options have been explored. There was no important increase of C. difficile associated disease in Maribor region in the last 10 years. We need to monitor the incidence of disease. Recognition of cases, properly management with aggressive treatment and good infection control practice are importnat for preventing the spread of disease in our region.
Summary		Clostridium difficile je pomemben povzročitelj drisk, ki se pojavijo po protimikrobnem zdravljenju. Okužba s C. difficile se lahko kaže kot asimptomatsko nosilstvo, lahko kot blaga driska, lahko pa povzroči tudi težke, življenje ogrožujoče klinične slike. V zadnjih letih ugotavljajo izrazit porast pogostosti obolenja, klinična slika pa je težja s pogostimi zapleti in pomembno smrtnostjo. Na ta pojav je verjetno vplivalo več dejavnikov s strani bolnika in dejavnikov okolja. Eden od pomembnih dejavnikov je tudi pojav novega, bolj virulentnega seva C. difficile. Kot zdravilo izbora velja metronidazol, vankomicin uporabljamo kt zdravilo drugega izbora. V zadnjih letih poročajo o vse slabši učinkovitosti navedene terapije in zato se iščejo še dodatne oz. druge možnosti zdravljenja. V mariborski regiji trenutno še ne ugotavljamo pomembnih razlik v pogostosti obolenja v obdobju zadnjih 10 let. Za učinkovit nadzor in preprečevanje je potrebno pravočasno prepoznavanje bolezni in ustrezna diagnostika ter optimalno zdravljenje in upoštevanje preventivnih ukrepov.
Descriptors		CLOSTRIDIUM DIFFICILE CLOSTRIDIUM DIFFICILE DIARRHEA INFECTION