Актуальные международные и национальные клинические рекомендации по профилактике, диагностике и лечению инфекции Clostridioides difficile у взрослых и детей: обзор, критические замечания и возможности применения в реальной клинической практике

Abstract

Clostridioides difficile is the most common cause of antibiotic-associated diarrhea in both inpatients and outpatients, and an important cause of nosocomial infection worldwide. The article reviews the Clinical Guidelines of the American College of Gastroenterology and other relevant international and national guidelines for the prevention, diagnosis, and treatment of C. difficile infection in adults and children, and critically discusses their applicability in real-life clinical practice. Current algorithms for the diagnosis of C. difficile infection in adults and children are presented. The role and place of vancomycin, fidaxomicin, metronidazole, rifaximin, bezlotoxumab, fecal microbiota transplantation, and probiotics in the treatment and prevention of C. difficile infection are reviewed and discussed. The diagnosis, treatment, and prevention of recurrent C. difficile infection in patients with inflammatory bowel disease are specifically considered. Innovative methods for the prevention and treatment of C. difficile infection using probiotics and microbiome-based therapeutics may provide an effective and safe alternative to fecal microbiota transplantation. Key words: Clostridioides difficile infection, toxins A and B, binary toxin, vancomycin, fidaxomycin, metronidazole, rifaximin, bezlotoxumab, probiotics, fecal microbiota transplantation, inflammatory bowel disease