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

Détails

ID Serval
serval:BIB_01C7BF9B84B7
Type
Article: article d'un périodique ou d'un magazine.
Sous-type
Synthèse (review): revue aussi complète que possible des connaissances sur un sujet, rédigée à partir de l'analyse exhaustive des travaux publiés.
Collection
Publications
Institution
Titre
Diagnostic and therapy of severe Clostridioides difficile infections in the ICU.
Périodique
Current opinion in critical care
Auteur⸱e⸱s
Guery B., Barbut F., Tschudin-Sutter S.
ISSN
1531-7072 (Electronic)
ISSN-L
1070-5295
Statut éditorial
Publié
Date de publication
10/2020
Peer-reviewed
Oui
Volume
26
Numéro
5
Pages
450-458
Langue
anglais
Notes
Publication types: Journal Article ; Review
Publication Status: ppublish
Résumé
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.
Mots-clé
Anti-Bacterial Agents/therapeutic use, Clostridioides, Clostridioides difficile, Clostridium Infections/diagnosis, Clostridium Infections/therapy, Humans, Intensive Care Units
Pubmed
Web of science
Création de la notice
13/08/2020 7:40
Dernière modification de la notice
18/07/2023 5:56
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