Diagnostic and therapy of severe Clostridioides difficile infections in the ICU.

Details

Serval ID
serval:BIB_01C7BF9B84B7
Type
Article: article from journal or magazin.
Publication sub-type
Review (review): journal as complete as possible of one specific subject, written based on exhaustive analyses from published work.
Collection
Publications
Institution
Title
Diagnostic and therapy of severe Clostridioides difficile infections in the ICU.
Journal
Current opinion in critical care
Author(s)
Guery B., Barbut F., Tschudin-Sutter S.
ISSN
1531-7072 (Electronic)
ISSN-L
1070-5295
Publication state
Published
Issued date
10/2020
Peer-reviewed
Oui
Volume
26
Number
5
Pages
450-458
Language
english
Notes
Publication types: Journal Article
Publication Status: ppublish
Abstract
The purpose of the review is to provide all the recent data focusing on the diagnostic and treatment of Clostridioides difficile infection in patients admitted in the ICU.
In the ICU, diagnosis remains complicated with a large number of alternative diagnosis. The treatment classically relies on vancomycin but fidaxomicin and fecal microbiota transplantation are now potential solutions in selected indications.
Data on ICU-related CDI remain limited and conflicting. To date, there is no unique and simple way to obtain a diagnosis for CDI, the combination of clinical signs and a two-step testing algorithm remains the recommended gold-standard. Two molecules can be proposed for first line treatment: vancomycin and fidaxomicin. Although metronidazole may still be discussed as a treatment option for mild CDI in low-risk patients, its use for ICU-patients does not seem reasonable. Several reports suggest that fecal microbiota transplantation could be discussed, as it is well tolerated and associated with a high rate of clinical cure. CDI is a dynamic and active area of research with new diagnostic techniques, molecules, and management concepts likely changing our approach to this old disease in the near future.
Pubmed
Web of science
Create date
13/08/2020 8:40
Last modification date
02/12/2020 7:24
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