В последнее время отмечается увеличение случаев инфекции, вызванной Clostridium difficile, с развитием тяжелого псевдомембранозного колита с высокой летальностью и большим процентом рецидивов. Псевдомембранозный колит должен быть заподозрен у всех больных, получающих антибиотики при развитии диареи, острых болей в животе, лейкоцитоза, гипопротеинемии. Данной категории пациентов показано проведение лабораторных исследований для выявления токсинов Clostridium difficile.
Recently there was an increase of Clostridium difficile infection cases with the development of severe pseudomembranous colitis with high mortality and high percentage of backsets. Major reason for this growing problem is the emergence of newer, more virulent and more antibiotic-resistant strains including PCR ribotype 027. The major risk factors for pseudomembranous colitis are hospitalizing, antibiotics exposure, chemotherapy, use of proton-pumps inhibitors, older age, concomitant diseases. The appearance of diarrhea, acute abdominal pain, leukocytosis, hypoproteinemia after antibiotic therapy should be considered as a basis for targeted diagnostics of pseudomembranous colitis with the use of laboratory tests. Fulminant pseudomembranous colitis occurs in 5 % of patient with Clostridium difficile infection. This patients often have severe abdominal pain and can have signs of peritonitis and a markedly increased white blood cells. Colectomy should be considered in patients with fulminant colitis. The mortality rate in fulminant pseudomembranous colitis is up to 70 %. The basis for the prevention of pseudomembranous colitis is a rational prescription of antibacterial agents.
The authors declare that there are no conflicts of interest present.