{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T18:13:19Z","timestamp":1793124799726,"version":"4.5.0"},"reference-count":0,"publisher":"National Institute of Public Health NIH (National Research Institute)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Przegl Epidemiol"],"abstract":"<p><strong>ABSTRACT<\/strong><br \/>Symptomatic <em>Clostridium difficile<\/em> infection (CDI) is an acute inflammatory disease of the gastrointestinal tract,\u00a0manifesting in at least 3 unformed stools within 24 hours. Predicting factors for CDI include contact with medical\u00a0care (mainly hospitalization), antibiotic therapy in the last 12 weeks, use of proton pump inhibitors (PPI), H2\u00a0blockers, cancer chemotherapy, especially in the neutropenia stage, gastrointestinal surgery, advanced age and\u00a0concomitant chronic diseases (renal failure, liver failure, chronic inflammatory bowel disease - especially ulcerative\u00a0bowel disease, cancer, HIV infection, cachexia and hypoalbuminaemia) and vitamin D deficiency. Clinical\u00a0classification distinguishes three types of CDI - mild \/ moderate, severe, and fulminant. The principles of treatment\u00a0of the first and subsequent CDI incidents depending on the clinical course are based on oral vancomycin.<br \/>CDI is recurrent. The basis for treating CDI relapses is vancomycin administered orally at a dose of 4x125 mg\u00a0for 10 days followed by concomitant vancomycin dose reduction therapy.<br \/>The use of fecal microbiota transfer (FMT) in the treatment of CDI relapses is considered to be the most effective\u00a0therapy for recurrent CDI. An indication for FMT is antibiotic-resistant <em>C. difficile<\/em> infection, regardless of\u00a0the number of incidents CDI. The panel of tests recommended for a bacterial flora donor is presented in the\u00a0recommendations.<\/p>\n<p>STRESZCZENIE<br \/>Objawowe zaka\u017cenie <em>Clostridium difficile<\/em> (<em>Clostridium difficile<\/em> infection, CDI) jest ostr\u0105 chorob\u0105 zapaln\u0105\u00a0przewodu pokarmowego, manifestuj\u0105c\u0105 si\u0119 co najmniej trzema nieuformowanymi stolcami w ci\u0105gu 24\u00a0godzin. Czynniki predysponuj\u0105ce do wyst\u0105pienia CDI to kontakt z opiek\u0105 medyczn\u0105 (g\u0142\u00f3wnie hospitalizacja),\u00a0antybiotykoterapia w ci\u0105gu ostatnich 12 tygodni, stosowanie inhibitor\u00f3w pompy protonowej (IPP), bloker\u00f3w\u00a0H2, chemioterapii nowotwor\u00f3w, szczeg\u00f3lnie w fazie neutropenii, chirurgia przewodu pokarmowego, podesz\u0142y\u00a0wiek i przewlek\u0142e choroby wsp\u00f3\u0142istniej\u0105ce (niewydolno\u015b\u0107 nerek, niewydolno\u015b\u0107 w\u0105troby, przewlek\u0142e zapalne\u00a0choroby jelit - szczeg\u00f3lnie wrzodziej\u0105ce zapalenie jelit, nowotwory, zaka\u017cenie HIV, choroby przebiegaj\u0105ce\u00a0z wyniszczeniem i hipoalbuminemi\u0105) oraz niedob\u00f3r witaminy D.<br \/>Kwalifikacja kliniczna wyr\u00f3\u017cnia 3 rodzaje przebiegu CDI - lekki\/umiarkowany, ci\u0119\u017cki i piorunuj\u0105cy. Zasady\u00a0leczenia pierwszego i kolejnych incydent\u00f3w CDI w zale\u017cno\u015bci od przebiegu klinicznego opieraj\u0105 si\u0119 na\u00a0stosowaniu wankomycyny doustnie. CDI ma charakter nawrotowy. Podstaw\u0105 leczenia nawrot\u00f3w CDI jest\u00a0wankomycyna stosowana doustnie w dawce 4x125 mg przez 10 dni z nast\u0119pczym zastosowaniem terapii\u00a0sto\u017ckowej wankomycyn\u0105 w zmniejszaj\u0105cych dawkach.<br \/>Zastosowanie transferu flory jelitowej (<em>fecal microbiota transfer<\/em>, FMT) w leczeniu nawrot\u00f3w CDI uwa\u017ca si\u0119\u00a0za najbardziej efektywn\u0105 terapi\u0119 nawrotowego CDI. Wskazaniem do wykonania FMT jest oporne na leczenie\u00a0antybiotykami zaka\u017cenie C. difficile, niezale\u017cnie od liczby incydent\u00f3w CDI. Panel bada\u0144 rekomendowanych\u00a0u dawcy flory bakteryjnej przedstawiono w rekomendacjach.<\/p><\/jats:p>","DOI":"10.32394\/pe.74.06","type":"journal-article","created":{"date-parts":[[2020,6,12]],"date-time":"2020-06-12T12:37:04Z","timestamp":1591965424000},"page":"69-87","source":"Crossref","is-referenced-by-count":10,"title":["Clinical practice guidelines for Clostridioides (Clostridium) difficile infection and fecal microbiota transplant protocol \u2013 recommendations of the Polish Society od Epidemiology and Infectious Diseases"],"prefix":"10.32394","volume":"74","author":[{"given":"A","family":"Piekarska","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A","family":"Panasiuk","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"P","family":"St\u0119pie\u0144","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"17323","published-online":{"date-parts":[[2020,5,27]]},"container-title":["Przeglad Epidemiologiczny"],"original-title":["Post\u0119powanie w zaka\u017ceniach Clostridioides (C"],"link":[{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180922-101485","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/pdf-180922-101485","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,3,8]],"date-time":"2024-03-08T08:45:44Z","timestamp":1709887544000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.przeglepidemiol.pzh.gov.pl\/Clinical-practice-guidelines-for-Clostridioides-Clostridium-difficile-infection-and,180922,0,2.html"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,5,27]]},"references-count":0,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2020]]}},"alternative-id":["180922"],"URL":"https:\/\/doi.org\/10.32394\/pe.74.06","relation":{},"ISSN":["0033-2100","2545-1898"],"issn-type":[{"value":"0033-2100","type":"print"},{"value":"2545-1898","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,5,27]]}}}