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Infections digestives à Clostridium difficile: diagnostic et traitement

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Infectiologie en réanimation

Part of the book series: Références en réanimation. Collection de la SRLF ((SRLF))

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Résumé

Depuis la découverte de son rôle dans les colites postantibiotiques en 1978, Clostridium difficile est devenu le principal agent de diarrhées associées aux soins. Les souches toxinogènes sont responsables de 10 à 25 % des diarrhées postantibiotiques et de plus de 95 % des cas de colites pseudomembraneuses (CPM). Depuis une dizaine d’années, C. difficile a connu une évolution épidémiologique tout à fait particulière à travers le monde : i) de nombreuses épidémies d’infections sévères ont été décrites, ii) l’incidence des infections à C. difficile (ICD) a augmenté dans de nombreux hôpitaux d’Amérique du Nord et d’Europe [1], iii) une souche dite « hypervirulente » (souche 027/NAP1/BI) a émergé et diffusé rapidement [2, 3], et iiii) davantage d’échecs cliniques ont été rapportés avec le métronidazole [4].

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Recommandations internationales

  1. Crobach MJ, Dekkers OM, Wilcox MH, Kuijper EJ (2009) European Society of Clinical Microbiology and Infectious Diseases (ESCMID): data review and recommendations for diagnosing Clostridium difficile-infection (CDI). Clin Microbiol Infect 15(12): 1053–66

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  3. Bauer MP, Kuijper EJ, van Dissel JT (2009) European Society of Clinical Microbiology and Infectious Diseases (ESCMID): treatment guidance document for Clostridium difficile infection (CDI). Clin Microbiol Infect 15(12): 1067–79

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Authors and Affiliations

  1. Unité d’hygiène et de lutte contre les infections nosocomiales, Hôpital Saint-Antoine, AP-HP, 184, rue du faubourg Saint-Antoine, 75571, Paris cedex 12, France

    F. Barbut

  2. Faculté Pierre et Martie Curie — Site Saint-Antoine, Laboratoire « Clostridium difficile » associé au CNR des Anaérobies et du Botulisme, 27 rue de Chaligny, 75571, Paris cedex 12, France

    F. Barbut & C. Eckert

  3. Service des maladies infectieuses et tropicales, Hôpital Saint-Antoine, AP-HP, 184, rue du faubourg Saint-Antoine, 75571, Paris cedex 12, France

    J.-L. Meynard & L. Surgers

  4. Service de réanimation médicale, Hôpital Saint-Antoine, AP-HP, 184, rue du faubourg Saint-Antoine, 75571, Paris cedex 12, France

    É. Maury

  5. Groupe de recherche clinique n° 2 « EPIDIFF », UPMC Univ. Paris 6, 27 rue de chaligny, 75012, Paris, France

    F. Barbut, J.-L. Meynard, É. Maury, L. Surgers & C. Eckert

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  1. F. Barbut
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  2. J.-L. Meynard
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  3. É. Maury
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  4. L. Surgers
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  5. C. Eckert
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Correspondence to F. Barbut .

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Barbut, F., Meynard, JL., Maury, É., Surgers, L., Eckert, C. (2013). Infections digestives à Clostridium difficile: diagnostic et traitement. In: Infectiologie en réanimation. Références en réanimation. Collection de la SRLF. Springer, Paris. https://doi.org/10.1007/978-2-8178-0389-0_25

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  • DOI: https://doi.org/10.1007/978-2-8178-0389-0_25

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