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DOI: 10.1055/s-2001-13295
Nosokomiale Epidemiologie und Transmission der Clostridium-difficile-Infektion
Nosocomial epidemiology and transmission of Clostridium difficile infectionPublication History
Publication Date:
31 December 2001 (online)

Hintergrund: Clostridium difficile ist ein zunehmend wichtiger Erreger Krankenhaus-erworbener Infektionen mit der pseudomembranösen Colitis als wesentlicher Erkrankung. Die Modalitäten der Transmission und auch der Epidemiologie des Erregers sind noch nicht vollständig geklärt.
Patienten und Methodik: Stuhlproben von 1164 Patienten (571 Frauen und 593 Männer) wurden hinsichtlich des Auftretens von C. difficile untersucht. Verlaufsuntersuchungen und die molekularbiologische Typisierung der Isolate wurden zur Klärung von etwaigen Infektionsketten und nosokomialen Transmissionen durchgeführt. Zusätzlich wurden Umfelduntersuchungen vorgenommen.
Ergebnisse: Die Inzidenz der C. difficile-Infektion im Untersuchungsgut betrug 8,4 %. Nahezu alle Patienten (92,9 %) waren mit Antibiotika vorbehandelt, mittels molekulargenetischer Methoden lässt sich eine nosokomiale Erregertransmission wahrscheinlich machen. Umfelduntersuchungen zeigen ein geringes Maß an kontaminierten Materialien, jedoch waren Toilettenstühle zu 15,4 % kontaminiert und stellen damit ein Risiko für nosokomiale Infektionen dar. Personaluntersuchungen erbrachten lediglich einen positiven Nachweis.
Folgerung: C. difficile ist ein Hospitalkeim, der erhebliche Ansprüche an das Patienten- und Hygienemanagement in der Klinik stellt.
Nosocomial epidemiology and transmission of Clostridium difficile infection
Background: Clostridium difficile is of growing importance as a hospital-acquired pathogen. Pseudomembraneous colitis is the main clinical disease. Transmission and epidemiological features are not yet fully understood.
Patients and methods: Stool samples from 1164 individuals (571 women and 593 men) attending were examined for the presence of C. difficile. Follow-up examinations and molecular typing methods were used for the detection nosocomial transmissions. Additionally, hospital-borne environmental samples as well as staff samples were tested.
Results: Incidence of C. difficile infection was 8,4 %. Nearly all patients (92,9 %) had antibiotics given. Using molecular typing nosocomial transmission was evident. Though, envrionmental samples in general had a low positivity, toilet chairs were contaminated in 15.4 % and may be a potential source of transmission. Staff was positive in only one case.
Conclusions: Prevention of infections with C. difficile becomes to be a maior threat for the clinical and hygienic management.
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Korrespondenz
Prof. Dr. Bernhard R. Ruf
2. Klinik für Innere Medizin Klinikum
St. Georg Leipzig
Delitzscher Straße 141
04129 Leipzig
Phone: +49/341/9092601
Fax: +49/341/9092630
Email: ruf@sanktgeorg.de