Die Stuhlübertragung als Therapieprinzip bei schwerer, wiederkehrender Clostridium-difficile-Infektion

C Lübbert; S Weis; E John; N Dietze; J Feisthammel; A Hoffmeister; J Mössner; H Kranz

doi:10.1055/s-0034-1378162

Endo-Praxis, Table of Contents

Endo-Praxis 2014; 30(2): 72-78
DOI: 10.1055/s-0034-1378162

Originalia

Die Stuhlübertragung als Therapieprinzip bei schwerer, wiederkehrender Clostridium-difficile-Infektion

C Lübbert

¹Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig

,

S Weis

¹Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig

,

E John

²Klinik für Allgemein-, Viszeral- und Gefäßchirurgie, Universitätsklinikum Halle (Saale)

,

N Dietze

³Institut für Medizinische Mikrobiologie und Infektionsepidemiologie, Universitätsklinikum Leipzig

,

J Feisthammel

¹Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig

,

A Hoffmeister

¹Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig

,

J Mössner

¹Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig

,

H Kranz

¹Klinik und Poliklinik für Gastroenterologie und Rheumatologie, Department für Innere Medizin, Neurologie und Dermatologie, Universitätsklinikum Leipzig

› Author Affiliations

Abstract

Die Wiederherstellung eines mikrobiellen Gleichgewichts im Kolon von Patienten mit rezidivierender Clostridium-difficile-Infektion mittels Stuhlübertragung von gesunden Spendern stellt eine hochwirksame Alternative zur antibiotischen Therapie dar.

Schlüsselwörter:

Clostridium difficile - Clostridium-difficile-asso-ziierte Diarrhö (CDAD) - Clostridium-difficile-Infektion (CDI) - Stuhlübertragung - Stuhltransplantation - Kolektomie - Antibiotika

Full Text

References

Literatur
1 Hall IC, O'Toole E. Intestinal flora in newborn infants with description of a new pathogenic anaerobe. Am J Dis Child 1935; 49: 390-402
2 Bartlett JG, Chang TW, Gurwith M et al. Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 1978; 298: 531-534
3 Larson HE, Price AB, Honour P et al. Clostridium difficile and the aetiology of pseudomembranous colitis. Lancet 1978; 1: 1063-1066
4 Kyne L, Hamel MB, Polavaram R et al. Health care costs and mortality associated with nosocomial diarrhea due to Clostridium difficile. Clin Infect Dis 2002; 34: 346-353
5 Vonberg RP, Reichardt C, Behnke M et al. Costs of nosocomial Clostridium difficile-associated diarrhoea. J Hosp Infect 2008; 70: 15-20
6 Bauer MP, Notermans DW, van Benthem BH et al. Clostridium difficile infection in Europe: a hospital-based survey. Lancet 2011; 377: 63-73
7 Hensgens MP, Goorhuis A, Dekkers OM et al. Time interval of increased risk for Clostridium difficile infection after exposure to antibiotics. J Antimicrob Chemother 2011; 67: 742-748
8 Grünewald T, Kist M, Mutters R et al. [Clostridium difficile infection]. Dtsch Med Wochenschr 2010; 135: 699-703
9 Burckhardt F, Friedrich A, Beier D et al. Clostridium difficile surveillance trends, Saxony, Germany. Emerg Infect Dis 2008; 14: 691-692
10 DuPont HL. The search for effective treatment of Clostridium difficile infection. N Engl J Med 2011; 364: 473-475
11 Lo Vecchio A, Zacur GM. Clostridium difficile infection: an update on epidemiology, risk factors, and therapeutic options. Curr Opin Gastroenterol 2012; 28: 1-9
12 Kuijper EJ, Coignard B, Tull P. Emergence of Clostridium difficile-associated disease in North America and Europe. Clin Microbiol Infect 2006; 12 (Suppl. 06) 2-18
13 Cohen SH, Gerding DN, 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: 431-455
14 Ackermann G. Clostridium difficile - Aktueller Stand. Mikrobiologe 2004; 123-129
15 Raveh D, Rabinowitz B, Breuer GS et al. Risk factors for Clostridium difficile toxin-positive nosocomial diarrhoea. Int J Antimicrob Agents 2006; 28: 231-237
16 Morteau O, Castagliuolo I, Mykoniatis A et al. Genetic deficiency in the chemokine receptor CCR1 protects against acute Clostridium difficile toxin A enteritis in mice. Gastroenterology 2002; 122: 725-733
17 Paredes-Sabja D, Sarker MR. Adherence of Clostridium difficile spores to Caco-2 cells in culture. J Med Microbiol 2012; 61: 1208-1218
18 Robert Koch-Institut. Ratgeber Infektionskrankheiten – Merkblätter für Ärzte: Clostridium difficile. Epidemiol Bull 2009; 24: 233-239
19 Crobach MJ, Dekkers OM, Wilcox MH et al. European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI). Clin Microbiol Infect 2009; 15: 1053-1066
20 Weis S, John E, Lippmann N et al. Clostridium difficile Infection (CDI) in the Course of Time - An Issue Only for the Internist?. Zentralbl Chir 2013;
21 RKI. Empfehlungen des Robert Koch-Institutes zu Hygienemaßnahmen bei Patienten mit Durchfällen aufgrund von toxinbildendem Clostridium difficile, Stand Dezember 2008. http://www.rki.de/DE/Content/Infekt/Krankenhaushygiene/Erreger_ausgewaehlt/Clostridium.html [last accessed 07.04.2013]
22 Bauer MP, Kuijper EJ, van Dissel JT. European Society of Clinical Microbiology and Infectious Diseases (ESCMID): treatment guidance document for Clostridium difficile infection (CDI). Clin Microbiol Infect 2009; 15: 1067-1079
23 Gerding DN, Muto CA, Owens Jr RC. Treatment of Clostridium difficile infection. Clin Infect Dis 2008; 46 (Suppl. 01) 32-42
24 Zar FA, Bakkanagari SR, Moorthi KM et al. A comparison of vancomycin and metronidazole for the treatment of Clostridium difficile-associated diarrhea, stratified by disease severity. Clin Infect Dis 2007; 45: 302-307
25 Pepin J. Vancomycin for the treatment of Clostridium difficile Infection: for whom is this expensive bullet really magic?. Clin Infect Dis 2008; 46: 1493-1498
26 Nelson R. Antibiotic treatment for Clostridium difficile-associated diarrhea in adults. Cochrane Database Syst Rev CD 004610 2007;
27 Pillai A, Nelson R. Probiotics for treatment of Clostridium difficile-associated colitis in adults. Cochrane Database Syst Rev CD 004611 2008;
28 Lowy I, Molrine DC, Leav BA et al. Treatment with monoclonal antibodies against Clostridium difficile toxins. N Engl J Med 2010; 362: 197-205
29 Louie TJ, Miller MA, Mullane KM et al. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med 2011; 364: 422-431
30 Brandt LJ, Aroniadis OC, Mellow M et al. Long-term follow-up of colonoscopic fecal microbiota transplant for recurrent Clostridium difficile infection. Am J Gastroenterol 2012; 107: 1079-1087
31 van Nood E, Vrieze A, Nieuwdorp M et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med 2013; 368: 407-415
32 Kleger A, Schnell J, Essig A et al. Fecal transplant in refractory Clostridium difficile colitis. Dtsch Arztebl Int 2013; 110: 108-15
33 Gross M, Meyer C. Stool transplantation for relapsing Clostridium difficile colitis. Z Gastroenterol 2013; 51: 1441-1443
34 Bhangu A, Nepogodiev D, Gupta A et al. Systematic review and meta-analysis of outcomes following emergency surgery for Clostridium difficile colitis. Br J Surg 2012; 99: 1501-1513
35 Dallal RM, Harbrecht BG, Boujoukas AJ et al. Fulminant Clostridium difficile: an underappreciated and increasing cause of death and complications. Ann Surg 2002; 235: 363-372
36 Koss K, Clark MA, Sanders DS et al. The outcome of surgery in fulminant Clostridium difficile colitis. Colorectal Dis 2006; 8: 149-154
37 Lamontagne F, Labbe AC, 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: 267-272
38 Jaber MR, Olafsson S, Fung WL et al. Clinical review of the management of fulminant clostridium difficile infection. Am J Gastroenterol 2008; 103
39 Pepin J, Vo TT, Boutros M et al. Risk factors for mortality following emergency colectomy for fulminant Clostridium difficile infection. Dis Colon Rectum 2009; 52: 400-405
40 Carchman EH, Peitzman AB, Simmons RL et al. The role of acute care surgery in the treatment of severe, complicated Clostridium difficile-associated disease. J Trauma Acute Care Surg 2012; 73: 789-800
41 Synnott K, Mealy K, Merry C et al. Timing of surgery for fulminating pseudomembranous colitis. Br J Surg 1998; 85: 229-231
42 Longo WE, Mazuski JE, Virgo KS et al. Outcome after colectomy for Clostridium difficile colitis. Dis Colon Rectum 2004; 47: 1620-1626
43 Ali SO, Welch JP, Dring RJ. Early surgical intervention for fulminant pseudomembranous colitis. Am Surg 2008; 74: 20-26
44 Byrn JC, Maun DC, Gingold DS et al. Predictors of mortality after colectomy for fulminant Clostridium difficile colitis. Arch Surg 2008; 143
45 Butala P, Divino CM. Surgical aspects of fulminant Clostridium difficile colitis. Am J Surg 2010; 200: 131-135
46 Neal MD, Alverdy JC, Hall DE et al. Diverting loop ileostomy and colonic lavage: an alternative to total abdominal colectomy for the treatment of severe, complicated Clostridium difficile associated disease. Ann Surg 2011; 254: 427-429
47 Nassour I, Carchman EH, Simmons RL et al. Novel management strategies in the treatment of severe Clostridium difficile infection. Adv Surg 2012; 46: 111-135
48 Miller AT, Tabrizian P, Greenstein AJ et al. Long-term follow-up of patients with fulminant Clostridium difficile colitis. J Gastrointest Surg 2009; 13: 956-959

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