Almanac of Clinical MedicineAlmanac of Clinical MedicineАльманах клинической медицины2072-05052587-9294Moscow Regional Research and Clinical Institute (MONIKI)176510.18786/2072-0505-2022-50-048REVIEW ARTICLEОБЗОРReview ArticleClostridioides difficile – a new name, the old problems with diagnosis and treatmentClostridioides difficile: название новое, проблемы диагностики и терапии прежниеhttps://orcid.org/0000-0001-8666-6118ZakharenkoSergey M.ЗахаренкоСергей Михайлович
Russian Federation

MD, PhD, Associate Professor, Deputy Director

канд. мед. наук, доцент, заместитель директора

zsm1@mail.ruPediatric Research and Clinical Center for Infectious DiseasesФГБУ «Детский научно-клинический центр инфекционных болезней Федерального медико-биологического агентства»19122022211220225063773912211202219122022Copyright ©; 2022, Zakharenko S.M.Copyright ©; 2022, Захаренко С.М.2022Zakharenko S.M.Захаренко С.М.https://creativecommons.org/licenses/by-nc/4.0https://almclinmed.ru/jour/article/view/1765

Clostridium difficile was reclassified in 2016 under a new name of Clostridioides difficile. In 2021 to 2022, some changes were implemented into the main clinical guidelines on the diagnosis and treatment of infections caused by this pathogen. A two-step algorithm based on identification of C. difficile and then its toxins is still recommended for the diagnosis. The treatment regimens for the first episode and relapses of C. difficile-associated infection are based on metronidazole, vancomycin and fidaxomycin. Additional effectiveness of therapy has been associated with the use of microbiocenosis-oriented technologies aimed at restoration of the colon microbiota. In the Russian Federation, all widely applied diagnostic methods are available and all recommended antimicrobials, except fidaxomycin, as well as bezlotoxumab and fecal microbiota transplantation.

Clostridium difficile была реклассифицирована в 2016 г. и получила новое наименование Clostridioides difficile. В 2021–2022 гг. внесены изменения в основные клинические рекомендации по диагностике и лечению инфекций, вызванных этим микроорганизмом. Для диагностики по-прежнему рекомендуется двухэтапный алгоритм, основанный на обнаружении C. difficile, а затем токсинов. Схемы терапии первого эпизода и рецидивов C. difficile-ассоциированной инфекции основаны на применении метронидазола, ванкомицина и фидаксомицина. Дополнительную эффективность терапии связывают с применением микробиоценоз-ориентированных технологий, направленных на восстановление микробиоты толстой кишки. В Российской Федерации доступны все широко применяемые методы диагностики и, за исключением фидаксомицина, все рекомендуемые антимикробные препараты, а также безлотоксумаб и трансплантация фекальной микробиоты.

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