Infektiöse Diarrhöen – Clostridium difficile und Noroviren als Auslöser

Durchfallerkrankungen sind häufige Erkrankungen des Gastrointestinaltrakts und eine der 5 häufigsten Todesursachen weltweit. Obwohl genaue epidemiologische Angaben fehlen, spielen Diarrhöen auch in entwickelten Ländern eine zunehmende Rolle. Dabei werden akute von chronischen Diarrhöen unterschieden. Die häufigsten Ursachen für eine akute Enteritis infectiosa sind virale und bakterielle Erreger. Im Fall einer bakteriellen Dysenterie sind antibiotikaassoziierte Durchfälle durch Clostridium difficle eine häufige nosokomiale Manifestation der Erkrankung. Bei den viralen Erregern sind Noroviren in etwa 90 % der Fälle Auslöser einer akuten, innerhalb von 48-72 Stunden meist selbstlimitierenden Diarrhö. Bakterielle Dysenterien werden, wenn notwendig, mit Antibiotika behandelt, wobei bei einigen Erregern zunehmende Resistenzentwicklungen zu beachten sind. Eine weiterführende mikrobiologische oder endoskopische Diagnostik ist nicht immer notwendig. Die Therapie orientiert sich an den klinischen Symptomen und berücksichtigt im Allgemeinen die Prävention sekundärer Komplikationen.

Diarrheas are frequent diseases of the gastrointestinal tract and one of the five most common causes of death worldwide. Despite absence of exact epidemiological data we know that diarrheas play an important role even in industrialized countries. Acute diarrheas and chronic diarrheas must be discriminated. Most common causes for an acute enteritis infectiosa are viral and bacterial agents. In case of a bacterial dysentery antibotica associated diarrheas by Clostridium difficile are a frequent nosocomial manifestation of the disease. In the case of viral agents Noroviruses are in 90 % triggers of an acute and within 48-72 hours selflimiting diarrhea. Bacterial dysenterias are treated if necessary with antibiotics, but growing resistances are observed. Continuative microbiological or endoscopic diagnostic measures are not always necessary. Therapeutic measures are oriented at clincical symptoms and consider normally the prevention of secondary complications.

Key words

Acute diarrheas - infectious enteritis - norovirus - Clostridium difficile

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