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UTICAJ MIKROBIOLOŠKE EFIKASNOSTI VANKOMICINA I METRONIDAZOLA NA POJAVU RELAPSA CLOSTRIDIUM DIFFICILE INFEKCIJE /
EFFECT OF MICROBIOLOGICAL EFFICACY OF VANCOMYCIN AND METRONIDAZOLE TO RELAPSE CLOSTRIDIUM DIFFICILE INFECTION

Authors

 

Slađana Mukić1, Nadica Kovačević2,3

1Zavod za javno zdravlje Valjevo, Centar za higijenu i humanu ekologiju, Valjevo, Srbija
2Zavod za javno zdravlje Valjevo, Centar za higijenu i humanu ekologiju, Valjevo, Srbija
3Klinički Centar Vojvodine, Klinika za infektivne bolesti, Novi Sad, Srbija

 

UDK: 616.98:579.852
615.33.015


The paper was received / Rad primljen: 3.12.2019. /

Accepted / Rad prihvaćen: 14.12.2019.

 


Correspondence to:


dr Slađana Mukić
Centar za higijenu i humanu ekologiju
Zavod za javno zdravlje Valjevo
Vladike Nikolaja 5, 14000 Valjevo
telefon: +381607052688
e-mail: sladjanamukic@gmail.com

 

 

Sažetak

 

Uvod. Infekcije uzrokovane sa Clostridium difficile (CDI) predstavljaju najčešću formu nozokomijalnih dijareja kod odraslih. Istraživanja su pokazala da fekalni nivo toksina CD može imati uticaja na težinu kliničke slike i stopu smrtnosti. Materijal i metode. Istraživanje je sprovedeno kao retrospektivna klinička studija rađena na Klinici za infektivne bolesti Kliničkog Centra Vojvodine u periodu od januara 2015. godine do januara 2019. godine. Mikrobiološka efikasnost primenjenih terapijskih protokola se procenjivala u odnosu na eliminaciju toksina C. difficile iz stolice.Rezultati. Istraživanjem je obuhvaćeno ukupno 304 bolesnika koji su u inicijalnoj epizodi CDI lečeni metronidazolom (138 bolesnika) ili vankomicinom (166 bolesnika) u trajanju od 10 dana. Metronidazol je bio uspešan u eliminaciji toksina kod 100/138 (72,46%) bolesnika, a vankomicin kod 148/166 (89,15%) (Fisher test, p=0,0024). Bolesnici lečeni metronidazolom kod kojih je registrovana perzistencija toksina C. difficile u stolici nakon završene terapije, su imali relaps u 12/38 (30,8%) slučajeva, a bolesnici lečeni vankomicinom u 6/34 (17,6%) slučajeva (p>0.005). Zaključak. Rezultati našeg istraživanja su pokazali da je vankomicin efikasniji u odnosu na metronidazol u eliminaciji toksina C. difficile iz crevnog trakta ali nismo dokazali da perzistencija toksina C. difficile u stolici nakon uspešno završene terapije prve epizode CDI utiče statistički značajno na pojavu relapsa ni kod bolesnika lečenih metronidazolom, ni kod bolesnika lečenih vankomicinom.

 

 

Ključne reči:

Clostridium difficile, toksin, vankomicin, metronidazol.

 

 

Abstract

 

Introduction. Infection caused by Clostridium difficile (CDI) are the most common form of nosocomial diarrhea in adults. Studies have shown that fecal levels of toxins CD can affect the severity of clinical symptoms and mortality. Material and methods. The survey was conducted as a retrospective clinical study was conducted at the Clinic for Infectious Diseases, Clinical Center of Vojvodina in the period from January 2015 to January 2019. Microbiological efficacy of the applied therapeutical protocols is assessed in relation to the elimination of toxins of C. difficile from a stool.Results. The study included a total of 304 patients treated with CDI in an initial episodes treated with metronidazole (138 patients) or vancomycin (166 patients) for a period of 10 days. Metronidazole has been successful in the elimination of toxins in 100/138 (72.46%) patients, and vancomycin at 148/166 (89.15%) (Fisher test, p = 0.0024). Patients treated with metronidazole were registered with the persistence of C. difficile toxin in stool after the therapy, had relapsed in 12/38 (30.8%) patients, patients treated with vancomycin in 6/34 (17.6%) cases (p > 0.005).Conclusion. The results of our investigations have shown that vancomycin is effective in assisting the metronidazole in the elimination of toxins of C. difficile from the intestinal tract or have not been demonstrated that the persistence of toxin C. difficile in stool after the successful completion of the first episode of CDI treatment significantly affects the occurrence of relapse in patients not treated with metronidazole, no patients treated with vancomycin.

 

Key words:

Clostridium difficile toxin, vancomycin, metronidazole.

 

 

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PDF Mukić S. and Kovačević N. et al • MD-Medical Data 2019;11(3-4): 137-140

 

 

 

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