caa a22 4500 606156224 CHVBK 20210128100607.0 cr unu---uuuuu 210128e20151201xx s 000 0 eng 10.1007/s10096-015-2501-z doi (NATIONALLICENCE)springer-10.1007/s10096-015-2501-z Clostridium difficile infection in patients with liver disease: a review [Elektronische Daten] [A. Trifan, O. Stoica, C. Stanciu, C. Cojocariu, A.-M. Singeap, I. Girleanu, E. Miftode] Over the past two decades, there has been a dramatic worldwide increase in both the incidence and severity of Clostridium difficile infection (CDI). Paralleling the increased incidence of CDI in the general population, there has been increased interest in CDI among patients with liver disease, particularly in those with liver cirrhosis and post liver transplantation. MEDLINE and several other electronic databases from January 1995 to December 2014 were searched in order to identify potentially relevant literature. Patients with cirrhosis and liver transplant recipients are at high risk for the development CDI because of antibiotics and proton pump inhibitors use, frequent and prolonged hospitalization, immunosuppressant therapy, and multiple comorbidities. Enzyme immunoassay to detect C. difficile toxins A and B in stool remains the most widely used test for CDI diagnosis, although, more recently, polymerase chain reaction (PCR)-based assays have become the preferred diagnostic test in many laboratories. Metronidazole and vancomycin, given orally, have proved to be effective in the treatment of CDI. Both cirrhotic patients and liver transplant recipients with CDI have longer length of hospital stay, increased mortality, and higher healthcare costs than those without CDI. A rapid diagnosis and adequate therapy of CDI are of paramount importance to improve liver disease patients' outcome. The aim of this review is to provide up-to-date information on the epidemiology, risk factors, pathogenesis, treatment, and outcomes in liver disease patients with CDI. Springer-Verlag Berlin Heidelberg, 2015 Trifan A. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut Stoica O. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut Stanciu C. Institute of Gastroenterology and Hepatology, "St. Spiridon” Emergency University Hospital, Independentei Street no. 1, 700111, Iasi, Romania aut Cojocariu C. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut Singeap A.-M "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut Girleanu I. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut Miftode E. Hospital of Infectious Diseases, "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/12(2015-12-01), 2313-2324 0934-9723 34:12<2313 2015 34 10096 https://doi.org/10.1007/s10096-015-2501-z text/html Onlinezugriff via DOI BK010053 XK010053 XK010000 Metadata rights reserved Springer special CC-BY-NC licence nationallicence 1 review-article jats NATIONALLICENCE NATIONALLICENCE NL-springer NATIONALLICENCE 856 40 https://doi.org/10.1007/s10096-015-2501-z text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Trifan A. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut NATIONALLICENCE 700 1- Stoica O. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut NATIONALLICENCE 700 1- Stanciu C. Institute of Gastroenterology and Hepatology, "St. Spiridon” Emergency University Hospital, Independentei Street no. 1, 700111, Iasi, Romania aut NATIONALLICENCE 700 1- Cojocariu C. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut NATIONALLICENCE 700 1- Singeap A.-M "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut NATIONALLICENCE 700 1- Girleanu I. "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut NATIONALLICENCE 700 1- Miftode E. Hospital of Infectious Diseases, "Gr. T. Popa” University of Medicine and Pharmacy, 700111, Iasi, Romania aut NATIONALLICENCE 773 0- European Journal of Clinical Microbiology & Infectious Diseases Springer Berlin Heidelberg 34/12(2015-12-01), 2313-2324 0934-9723 34:12<2313 2015 34 10096