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Intensivmedizin up2date 2012; 08(02): 81-91
DOI: 10.1055/s-0032-1306906
Allgemeine Prinzipien der Intensivmedizin
© Georg Thieme Verlag KG Stuttgart · New York

Clostridium difficile – state of the art

Maria Martin
,
Winfried V. Kern
,
Markus Dettenkofer
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Publication History

Publication Date:
03 May 2012 (online)

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Kernaussagen

  • Fallzahl und Erkrankungsschwere von Clostridium-difficile-Infektionen (CDI) nehmen in den vergangenen Jahren deutlich zu.

  • Das Risiko für eine nosokomiale CDI ist nach den Daten des NRZ für Surveillance nosokomialer Infektionen etwa doppelt so hoch wie für MRSA.

  • Wichtigster Risikofaktor ist eine antibiotische Therapie, insbesondere mit Cephalosporinen, Fluorchinolonen und Clindamycin.

  • Der rationale Einsatz von Antibiotika – klare Indikation, schmales Erregerspektrum und kurze Therapiedauer – ist für die Primärprävention einer CDI von großer Bedeutung.

  • Konsequent umgesetzte krankenhaushygienische Maßnahmen verhindern die Verbreitung von C. difficile.

  • Therapie der Wahl sind nach wie vor Metronidazol oder Vancomycin oral, Fidaxomicin scheint eine vielversprechende Alternative zu sein.

  • Für schwer verlaufende Fälle besteht in Deutschland eine Meldepflicht.

 

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