Aktuelles zu Clostridium-difficile-Infektionen

Zusammenfassung

Die Clostridium difficile Infektion (CDI) ist ein häufiges und komplexes Krankheitsbild, bei dem das Repertoire bakterieller Virulenzfaktoren, die Wirtsimmunität und das Mikrobiom des Darms gleichermaßen verantwortlich für den klinischen Verlauf sind. Dadurch ergeben sich neue Interventionsmöglichkeiten, die auch therapeutisch genutzt werden können. Exemplarisch dafür steht die Therapie mit fäkalem Mikrobiom-Transfer (FMT) oder die Verwendung von Teilen der normalen Mikroflora als „next-generation Probiotika“ für die Prophylaxe und Therapie. Solche neuen Therapieformen können mit zunehmendem Wissen um die relevanten Mikroorganismen in Zukunft auch für andere Krankheiten adaptiert werden. CDI führen uns vor Augen, dass Antibiotikatherapien schwere Nebenwirkungen haben können. C. difficile kann somit als „schlechtes Gewissen der Antibiotikatherapie“ betrachtet werden, das hoffentlich dazu beitragen wird, Antibiotika in Zukunft immer gezielter und intelligenter einzusetzen.

Abstract

Clostridium difficile infection (CDI) is a frequent and complex disease which is influenced by the repertoire of bacterial virulence factors, by host immunity and by the intestinal microbiome. These complex interaction opens a number of options which may be used for treatment in the future. One example for new treatment options is fecal microbiota transplantation (FMT). Driven by C. difficile related research activities the knowledge of protective microorganism is increasing and it may be assumed that bacteriotherapy by next-generation probiotics may be used very soon also for other diseases. Very often, CDI reflects to the clinician that antibiotic therapy is associated with side effects. Therefore, C. difficile is the guilty conscience which helps to implement targeted and restrictive antibiotic use in the daily practice.

Schlüsselwörter

Clostridium difficile - Epidemiologie - Diagnostik - Therapie

Keywords

clostridium difficile - epidemiology - diagnosis - therapy

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