<?xml version="1.0" encoding="UTF-8"?>
<!DOCTYPE article PUBLIC "-//NLM//DTD JATS (Z39.96) Journal Publishing DTD v1.3 20210610//EN" "JATS-journalpublishing1-3.dtd">
<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="ru"><front><journal-meta><journal-id journal-id-type="publisher-id">medsovet</journal-id><journal-title-group><journal-title xml:lang="ru">Медицинский Совет</journal-title><trans-title-group xml:lang="en"><trans-title>Meditsinskiy sovet = Medical Council</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2079-701X</issn><issn pub-type="epub">2658-5790</issn><publisher><publisher-name>REMEDIUM GROUP Ltd.</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.21518/2079-701X-2017-19-126-133</article-id><article-id custom-type="elpub" pub-id-type="custom">medsovet-2201</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛУБ ЭКСПЕРТОВ ESPGHAN</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>ESPGHAN EXPERT CLUB</subject></subj-group></article-categories><title-group><article-title>АНТИБИОТИК-АССОЦИИРОВАННЫЕ ДИАРЕИ У ДЕТЕЙ: ЧТО НОВОГО?</article-title><trans-title-group xml:lang="en"><trans-title>ANTIBIOTIC ASSOCIATED DIARHEAS IN CHILDREN: WHAT’S NEW?</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Захарова</surname><given-names>И. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Zakharova</surname><given-names>I. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>д.м.н., профессор,</p><p>Москва</p></bio><bio xml:lang="en"><p>MD, Prof., </p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Бережная</surname><given-names>И. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Berezhnaya</surname><given-names>I. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>к.м.н.,</p><p>Москва</p></bio><bio xml:lang="en"><p>PhD in medicine,</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Сугян</surname><given-names>Н. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Sugyan</surname><given-names>N. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Москва</p></bio><bio xml:lang="en"><p>PhD in medicine,</p><p>Moscow</p></bio><xref ref-type="aff" rid="aff-1"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Российская медицинская академия непрерывного профессионального образования Минздрава России</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Russian Medical Academy of Continuous Postgraduate Education of the Ministry of Health of Russia</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2017</year></pub-date><pub-date pub-type="epub"><day>15</day><month>12</month><year>2017</year></pub-date><volume>0</volume><issue>19</issue><fpage>126</fpage><lpage>133</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Захарова И.Н., Бережная И.В., Сугян Н.Г., 2017</copyright-statement><copyright-year>2017</copyright-year><copyright-holder xml:lang="ru">Захарова И.Н., Бережная И.В., Сугян Н.Г.</copyright-holder><copyright-holder xml:lang="en">Zakharova I.N., Berezhnaya I.V., Sugyan N.G.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.med-sovet.pro/jour/article/view/2201">https://www.med-sovet.pro/jour/article/view/2201</self-uri><abstract><p>В статье представлены данные по распространенности инфекционных заболеваний у детей в России и частоте применения антибактериальной терапии. Уделено особое внимание бесконтрольному применению антибиотиков, что приводит к антибиотикорезистентности, нарушению равновесия симбиотной микробиоты, развитию острых аллергических реакций и других заболеваний. Приведена современная тактика лечения детей с антибиотик-ассоциированной диареей согласно международным рекомендациям ESPGHAN и ESPID.</p></abstract><trans-abstract xml:lang="en"><p>The article presents data on the prevalence of infectious diseases in children in Russia and the frequency of use of antibiotic therapy. Special attention is given to the uncontrolled use of antibiotics that leads to antibiotic resistance, disruption of the symbiotic equilibrium of the microbiota, development of acute allergic reactions and other diseases. The modern tactics of treatment of children with antibiotic-associated diarrhea according to the international recommendations of ESPGHAN and ESPID is provided.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>дети</kwd><kwd>антибиотик-ассоциированная диарея</kwd><kwd>Clostridium difficile</kwd><kwd>лечение</kwd><kwd>Смекта®</kwd><kwd>Lactobacillus GG</kwd></kwd-group><kwd-group xml:lang="en"><kwd>children</kwd><kwd>antibiotic-associated diarrhea</kwd><kwd>Clostridium difficile</kwd><kwd>treatment</kwd><kwd>Smecta®</kwd><kwd>Lactobacillus GG</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Gill SR, et al. Metagenomic analysis of the human distal gut microbiome. Science, 2006, 312: 1355–1359.</mixed-citation><mixed-citation xml:lang="en">Gill SR, et al. Metagenomic analysis of the human distal gut microbiome. Science, 2006, 312: 1355–1359.</mixed-citation></citation-alternatives></ref><ref id="cit2"><label>2</label><citation-alternatives><mixed-citation xml:lang="ru">Kau AL, Ahern PP, Griffin NW, Goodman AL, Gordon JI. Human nutrition, the gut microbiome and the immune system. Nature, 2011, 474: 327–336.</mixed-citation><mixed-citation xml:lang="en">Kau AL, Ahern PP, Griffin NW, Goodman AL, Gordon JI. Human nutrition, the gut microbiome and the immune system. Nature, 2011, 474: 327–336.</mixed-citation></citation-alternatives></ref><ref id="cit3"><label>3</label><citation-alternatives><mixed-citation xml:lang="ru">Инфекционная заболеваемость в Российской Федерации за январь 2016 г. (по данным формы №1 «Сведения об инфекционных и паразитарных заболеваниях»).</mixed-citation><mixed-citation xml:lang="en">Инфекционная заболеваемость в Российской Федерации за январь 2016 г. (по данным формы №1 «Сведения об инфекционных и паразитарных заболеваниях»).</mixed-citation></citation-alternatives></ref><ref id="cit4"><label>4</label><citation-alternatives><mixed-citation xml:lang="ru">Van Boeckel TP, Gandra S, Ashok A, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis, 2014, 14: 742-50.</mixed-citation><mixed-citation xml:lang="en">Van Boeckel TP, Gandra S, Ashok A, et al. Global antibiotic consumption 2000 to 2010: an analysis of national pharmaceutical sales data. Lancet Infect Dis, 2014, 14: 742-50.</mixed-citation></citation-alternatives></ref><ref id="cit5"><label>5</label><citation-alternatives><mixed-citation xml:lang="ru">Turnbaugh PJ, et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature, 2006, 444: 1027–1031.</mixed-citation><mixed-citation xml:lang="en">Turnbaugh PJ, et al. An obesity-associated gut microbiome with increased capacity for energy harvest. Nature, 2006, 444: 1027–1031.</mixed-citation></citation-alternatives></ref><ref id="cit6"><label>6</label><citation-alternatives><mixed-citation xml:lang="ru">McArdle MA, Finucane OM, Connaughton RM, et al. Mechanisms of obesity-induced inflammation and insulin resistance: insights into the emerging role of nutritionalstrategies. Frontiersin Endocrinology, 2013, 4(52).</mixed-citation><mixed-citation xml:lang="en">McArdle MA, Finucane OM, Connaughton RM, et al. Mechanisms of obesity-induced inflammation and insulin resistance: insights into the emerging role of nutritionalstrategies. Frontiersin Endocrinology, 2013, 4(52).</mixed-citation></citation-alternatives></ref><ref id="cit7"><label>7</label><citation-alternatives><mixed-citation xml:lang="ru">Lee J. Adipose tissue macrophages in the development of obesity-induced inflammation, insulin resistance and type 2 Diabetes. Archives of Pharmacal Research, 2013, 36: 208–222.</mixed-citation><mixed-citation xml:lang="en">Lee J. Adipose tissue macrophages in the development of obesity-induced inflammation, insulin resistance and type 2 Diabetes. Archives of Pharmacal Research, 2013, 36: 208–222.</mixed-citation></citation-alternatives></ref><ref id="cit8"><label>8</label><citation-alternatives><mixed-citation xml:lang="ru">Marrs T, Flohr C. How do Microbiota Influence the Development and Natural History of Eczema and Food Allergy? The Pediatric Infectious Disease Journal, 2016 November, 35(11): 1258-1261.</mixed-citation><mixed-citation xml:lang="en">Marrs T, Flohr C. How do Microbiota Influence the Development and Natural History of Eczema and Food Allergy? The Pediatric Infectious Disease Journal, 2016 November, 35(11): 1258-1261.</mixed-citation></citation-alternatives></ref><ref id="cit9"><label>9</label><citation-alternatives><mixed-citation xml:lang="ru">ВОЗ: Лечение диареи, 2006.</mixed-citation><mixed-citation xml:lang="en">ВОЗ: Лечение диареи, 2006.</mixed-citation></citation-alternatives></ref><ref id="cit10"><label>10</label><citation-alternatives><mixed-citation xml:lang="ru">Bartlett JG. Antibiotic-associated diarrhea. N Engl J Med, 2002, 346: 334–339.</mixed-citation><mixed-citation xml:lang="en">Bartlett JG. Antibiotic-associated diarrhea. N Engl J Med, 2002, 346: 334–339.</mixed-citation></citation-alternatives></ref><ref id="cit11"><label>11</label><citation-alternatives><mixed-citation xml:lang="ru">Barakat Maha, El-Kady Zeinab, Mostafa Mohamed, Naglaa Ibrahim and Hamdy Ghazaly. Antibiotic-associated Bloody Diarrhea in Infants: Clinical, Endoscopic and Histopathologic Profiles. JPGN, Jan 2011, 52(1).</mixed-citation><mixed-citation xml:lang="en">Barakat Maha, El-Kady Zeinab, Mostafa Mohamed, Naglaa Ibrahim and Hamdy Ghazaly. Antibiotic-associated Bloody Diarrhea in Infants: Clinical, Endoscopic and Histopathologic Profiles. JPGN, Jan 2011, 52(1).</mixed-citation></citation-alternatives></ref><ref id="cit12"><label>12</label><citation-alternatives><mixed-citation xml:lang="ru">LaRosa M, Bottaro G, Gulino N, et al. Prevention of antibiotic–associated diarrhea with Lactobacillus sporogens and fructo–oligosaccharides in children: a multi-centric doubleblind vs. placebo study. Minerva Pediatr, 2003, 55: 447–52.</mixed-citation><mixed-citation xml:lang="en">LaRosa M, Bottaro G, Gulino N, et al. Prevention of antibiotic–associated diarrhea with Lactobacillus sporogens and fructo–oligosaccharides in children: a multi-centric doubleblind vs. placebo study. Minerva Pediatr, 2003, 55: 447–52.</mixed-citation></citation-alternatives></ref><ref id="cit13"><label>13</label><citation-alternatives><mixed-citation xml:lang="ru">Turck D, Bernet JP, Marx J, et al. Incidence and risk factors for of oral antibiotic–associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr, 2003, 37: 22–6.</mixed-citation><mixed-citation xml:lang="en">Turck D, Bernet JP, Marx J, et al. Incidence and risk factors for of oral antibiotic–associated diarrhea in an outpatient pediatric population. J Pediatr Gastroenterol Nutr, 2003, 37: 22–6.</mixed-citation></citation-alternatives></ref><ref id="cit14"><label>14</label><citation-alternatives><mixed-citation xml:lang="ru">McFarland LV. Diarrhea acquired in the hospital. Gastroenterol Clin North Am, 1993, 22: 563–577.</mixed-citation><mixed-citation xml:lang="en">McFarland LV. Diarrhea acquired in the hospital. Gastroenterol Clin North Am, 1993, 22: 563–577.</mixed-citation></citation-alternatives></ref><ref id="cit15"><label>15</label><citation-alternatives><mixed-citation xml:lang="ru">Hogenauer C, Hammer HF, Krejs GJ, Reisinger EC. Mechanisms and management of antibiotic-associated diarrhea. Clin Infect Dis, 1998, 27: 702-710.</mixed-citation><mixed-citation xml:lang="en">Hogenauer C, Hammer HF, Krejs GJ, Reisinger EC. Mechanisms and management of antibiotic-associated diarrhea. Clin Infect Dis, 1998, 27: 702-710.</mixed-citation></citation-alternatives></ref><ref id="cit16"><label>16</label><citation-alternatives><mixed-citation xml:lang="ru">Захарова И.Н., Дмитриева Ю.А. Антибиотико-ассоциированные диареи: лечение и профилактика. Consilium medicum. Педиатрия, 2009, 2: 7-10.</mixed-citation><mixed-citation xml:lang="en">Захарова И.Н., Дмитриева Ю.А. Антибиотико-ассоциированные диареи: лечение и профилактика. Consilium medicum. Педиатрия, 2009, 2: 7-10.</mixed-citation></citation-alternatives></ref><ref id="cit17"><label>17</label><citation-alternatives><mixed-citation xml:lang="ru">Hempel S, Newberry SJ, Maher AR et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea. A Systematic Review and Meta-analysis. JAMA, 2012 May 9, 307(18).</mixed-citation><mixed-citation xml:lang="en">Hempel S, Newberry SJ, Maher AR et al. Probiotics for the Prevention and Treatment of Antibiotic-Associated Diarrhea. A Systematic Review and Meta-analysis. JAMA, 2012 May 9, 307(18).</mixed-citation></citation-alternatives></ref><ref id="cit18"><label>18</label><citation-alternatives><mixed-citation xml:lang="ru">Boyce JM, Havill NL. Nosocomial antibioticassociated diarrhea associated with enterotoxin-producing strains of methicillin–resistant Staphylococcus aureus. Am J Gastroenterol, 2005 Aug, 100(8): 1828–34.</mixed-citation><mixed-citation xml:lang="en">Boyce JM, Havill NL. Nosocomial antibioticassociated diarrhea associated with enterotoxin-producing strains of methicillin–resistant Staphylococcus aureus. Am J Gastroenterol, 2005 Aug, 100(8): 1828–34.</mixed-citation></citation-alternatives></ref><ref id="cit19"><label>19</label><citation-alternatives><mixed-citation xml:lang="ru">Шевяков М.А. Антибиотик-ассоциированная диарея и кандидоз кишечника: возможности лечения и профилактики. Антибиотики и химиотерапия, 2004, 49(10): 26-29.</mixed-citation><mixed-citation xml:lang="en">Шевяков М.А. Антибиотик-ассоциированная диарея и кандидоз кишечника: возможности лечения и профилактики. Антибиотики и химиотерапия, 2004, 49(10): 26-29.</mixed-citation></citation-alternatives></ref><ref id="cit20"><label>20</label><citation-alternatives><mixed-citation xml:lang="ru">Krause R, Reisinger EC. Candida and antibiotic– associated diarrhea. Clin Microbiol Infect, 2005, 11: 1–2.</mixed-citation><mixed-citation xml:lang="en">Krause R, Reisinger EC. Candida and antibiotic– associated diarrhea. Clin Microbiol Infect, 2005, 11: 1–2.</mixed-citation></citation-alternatives></ref><ref id="cit21"><label>21</label><citation-alternatives><mixed-citation xml:lang="ru">Hogenauer C, Langner C, Beubler E et al. Klebsiella oxytoca as a causative organism of antibiotic-associated hemorrhagic colitis. N Engl J Med, 2006, 355: 2418–26.</mixed-citation><mixed-citation xml:lang="en">Hogenauer C, Langner C, Beubler E et al. Klebsiella oxytoca as a causative organism of antibiotic-associated hemorrhagic colitis. N Engl J Med, 2006, 355: 2418–26.</mixed-citation></citation-alternatives></ref><ref id="cit22"><label>22</label><citation-alternatives><mixed-citation xml:lang="ru">Zollner-Scwetz I et al. Role of Klebsiella oxytoca in Antibiotic-Associated Diarrhea. Clinical Infectious Diseases Journal, 2008, 47: e74-8.</mixed-citation><mixed-citation xml:lang="en">Zollner-Scwetz I et al. Role of Klebsiella oxytoca in Antibiotic-Associated Diarrhea. Clinical Infectious Diseases Journal, 2008, 47: e74-8.</mixed-citation></citation-alternatives></ref><ref id="cit23"><label>23</label><citation-alternatives><mixed-citation xml:lang="ru">Малов В.А. Инфекция Clostridium Difficile: современное состояние проблемы. Фарматека, 2010, 4.</mixed-citation><mixed-citation xml:lang="en">Малов В.А. Инфекция Clostridium Difficile: современное состояние проблемы. Фарматека, 2010, 4.</mixed-citation></citation-alternatives></ref><ref id="cit24"><label>24</label><citation-alternatives><mixed-citation xml:lang="ru">Hickson M, D’Souza A, Muthu N et al. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ, 2007, 335: 80.</mixed-citation><mixed-citation xml:lang="en">Hickson M, D’Souza A, Muthu N et al. Use of probiotic Lactobacillus preparation to prevent diarrhoea associated with antibiotics: randomised double blind placebo controlled trial. BMJ, 2007, 335: 80.</mixed-citation></citation-alternatives></ref><ref id="cit25"><label>25</label><citation-alternatives><mixed-citation xml:lang="ru">Ayyagari A, Agarwal J, Garg A. Antibiotic associated diarrhoea: Infectious causes. Indian Journal of Medical Microbiology, 2003, 21(1): 6–11.</mixed-citation><mixed-citation xml:lang="en">Ayyagari A, Agarwal J, Garg A. Antibiotic associated diarrhoea: Infectious causes. Indian Journal of Medical Microbiology, 2003, 21(1): 6–11.</mixed-citation></citation-alternatives></ref><ref id="cit26"><label>26</label><citation-alternatives><mixed-citation xml:lang="ru">Hedge DD, Strain JD, Heins JR, Farver DK. New advances in the treatment of Clostridium difficile infection (CDI). Therapeutics and Clinical Risk Management, 2008, 4(5).</mixed-citation><mixed-citation xml:lang="en">Hedge DD, Strain JD, Heins JR, Farver DK. New advances in the treatment of Clostridium difficile infection (CDI). Therapeutics and Clinical Risk Management, 2008, 4(5).</mixed-citation></citation-alternatives></ref><ref id="cit27"><label>27</label><citation-alternatives><mixed-citation xml:lang="ru">Ивашкин В.Т., Ющук Н.Д., Маев И.В., Лапина Т.Л., Полуэктова Е.А., Шифрин О.С., Тертычный А.С., Трухманов А.С., Шептулин А.А., Баранская Е.К., Ляшенко О.С., Ивашкин К.В. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению Clostridium difficile-ассоциированной болезни. Российский журнал гастроэнтерологии, гепатологии, колопроктологии, 2016, 26(5): 56-65.</mixed-citation><mixed-citation xml:lang="en">Ивашкин В.Т., Ющук Н.Д., Маев И.В., Лапина Т.Л., Полуэктова Е.А., Шифрин О.С., Тертычный А.С., Трухманов А.С., Шептулин А.А., Баранская Е.К., Ляшенко О.С., Ивашкин К.В. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению Clostridium difficile-ассоциированной болезни. Российский журнал гастроэнтерологии, гепатологии, колопроктологии, 2016, 26(5): 56-65.</mixed-citation></citation-alternatives></ref><ref id="cit28"><label>28</label><citation-alternatives><mixed-citation xml:lang="ru">Marra AR, Edmond MB, Wenzel RP, Bearman GM. Hospitalacquired Clostridium difficileassociated disease in the intensive care unit setting: epidemiology, clinical course and outcome. BMC Infect Dis, 2007, 7(42).</mixed-citation><mixed-citation xml:lang="en">Marra AR, Edmond MB, Wenzel RP, Bearman GM. Hospitalacquired Clostridium difficileassociated disease in the intensive care unit setting: epidemiology, clinical course and outcome. BMC Infect Dis, 2007, 7(42).</mixed-citation></citation-alternatives></ref><ref id="cit29"><label>29</label><citation-alternatives><mixed-citation xml:lang="ru">Lupse M, Flonta M, Cioara A, Filipescu I, Todor N. Predictors of First Recurrence in Clostridium di¬cile-Associated Disease. A Study of 306 Patients Hospitalized in a Romanian Tertiary Referral Center. J Gastrointestin Liver Dis, 2013 Dec, 22(4): 397–403.</mixed-citation><mixed-citation xml:lang="en">Lupse M, Flonta M, Cioara A, Filipescu I, Todor N. Predictors of First Recurrence in Clostridium di¬cile-Associated Disease. A Study of 306 Patients Hospitalized in a Romanian Tertiary Referral Center. J Gastrointestin Liver Dis, 2013 Dec, 22(4): 397–403.</mixed-citation></citation-alternatives></ref><ref id="cit30"><label>30</label><citation-alternatives><mixed-citation xml:lang="ru">Harris AD, Pineles L, Belton B, et al. Universal Glove and Gown Use and Acquisition of Antibiotic-Resistant Bacteria in the ICU: A Randomized Trial. JAMA, 2013, 310(15): 1571-1580.</mixed-citation><mixed-citation xml:lang="en">Harris AD, Pineles L, Belton B, et al. Universal Glove and Gown Use and Acquisition of Antibiotic-Resistant Bacteria in the ICU: A Randomized Trial. JAMA, 2013, 310(15): 1571-1580.</mixed-citation></citation-alternatives></ref><ref id="cit31"><label>31</label><citation-alternatives><mixed-citation xml:lang="ru">Захарова И.Н., Мазанкова Л.Н. и соавт. Антибиотик-ассоциированные диареи у детей: проблема и решение. М., 2011. 48 с.</mixed-citation><mixed-citation xml:lang="en">Захарова И.Н., Мазанкова Л.Н. и соавт. Антибиотик-ассоциированные диареи у детей: проблема и решение. М., 2011. 48 с.</mixed-citation></citation-alternatives></ref><ref id="cit32"><label>32</label><citation-alternatives><mixed-citation xml:lang="ru">Curtin BF, Zarbalian Y, Flasar MH, von Rosenvinge E. Clostridium difficile -associated disease: Adherence with current guidelines at a tertiary medical center. World J Gastroentero, 2013 Dec 14, 19(46): 8647–8651.</mixed-citation><mixed-citation xml:lang="en">Curtin BF, Zarbalian Y, Flasar MH, von Rosenvinge E. Clostridium difficile -associated disease: Adherence with current guidelines at a tertiary medical center. World J Gastroentero, 2013 Dec 14, 19(46): 8647–8651.</mixed-citation></citation-alternatives></ref><ref id="cit33"><label>33</label><citation-alternatives><mixed-citation xml:lang="ru">Nyc O, Pituch H, Matejkova J, ObuchWoszczatynski P, Kuijper EJ. Clostridium difficile PCR ribotype 176 in the Czech Republic and Poland. Lancet,. 2011 Apr 23, 377(9775): 1407.</mixed-citation><mixed-citation xml:lang="en">Nyc O, Pituch H, Matejkova J, ObuchWoszczatynski P, Kuijper EJ. Clostridium difficile PCR ribotype 176 in the Czech Republic and Poland. Lancet,. 2011 Apr 23, 377(9775): 1407.</mixed-citation></citation-alternatives></ref><ref id="cit34"><label>34</label><citation-alternatives><mixed-citation xml:lang="ru">Nylund CM, Goudie A, Garza JM, Fairbrother G, Cohen M.B. Clostridium difficile infection in hospitalized children in the United States. Arch Pediatr Adolesc Med, 2011, 165: 451–457. PMID: 21199971 DOI: 10.1001/archpediatrics.2010.282.</mixed-citation><mixed-citation xml:lang="en">Nylund CM, Goudie A, Garza JM, Fairbrother G, Cohen M.B. Clostridium difficile infection in hospitalized children in the United States. Arch Pediatr Adolesc Med, 2011, 165: 451–457. PMID: 21199971 DOI: 10.1001/archpediatrics.2010.282.</mixed-citation></citation-alternatives></ref><ref id="cit35"><label>35</label><citation-alternatives><mixed-citation xml:lang="ru">Lupse M, Flonta M, Cioara A, Filipescu I, Todor N. Predictors of First Recurrence in Clostridium difficile-Associated Disease. A Study of 306 Patients Hospitalized in a Romanian Tertiary Referral Center. J Gastrointestin Liver Dis, 2013 December, 22(4): 397-403.</mixed-citation><mixed-citation xml:lang="en">Lupse M, Flonta M, Cioara A, Filipescu I, Todor N. Predictors of First Recurrence in Clostridium difficile-Associated Disease. A Study of 306 Patients Hospitalized in a Romanian Tertiary Referral Center. J Gastrointestin Liver Dis, 2013 December, 22(4): 397-403.</mixed-citation></citation-alternatives></ref><ref id="cit36"><label>36</label><citation-alternatives><mixed-citation xml:lang="ru">Minino A, Xu J and Kochanek K. Deaths: preliminary data for 2008. National Vital Statistics Report 59. Hyattsville, MD: National Center for Health Statistics. 2010. Available at: http: // www.cdc.gov/ nchs/data/nvsr/nvsr59/ nvsr59_02.pdf/</mixed-citation><mixed-citation xml:lang="en">Minino A, Xu J and Kochanek K. Deaths: preliminary data for 2008. National Vital Statistics Report 59. Hyattsville, MD: National Center for Health Statistics. 2010. Available at: http: // www.cdc.gov/ nchs/data/nvsr/nvsr59/ nvsr59_02.pdf/</mixed-citation></citation-alternatives></ref><ref id="cit37"><label>37</label><citation-alternatives><mixed-citation xml:lang="ru">Bauer MP, Notermans DW, van Benthem BH, Brazier JS, Wilcox MH, Rupnik M, Monnet DL, van Dissel JT, Kuijper EJ, ECDIS Study Group. Clostridium difficile infection in Europe: a hospital-based survey. Lancet, 2011, 377: 63-73.</mixed-citation><mixed-citation xml:lang="en">Bauer MP, Notermans DW, van Benthem BH, Brazier JS, Wilcox MH, Rupnik M, Monnet DL, van Dissel JT, Kuijper EJ, ECDIS Study Group. Clostridium difficile infection in Europe: a hospital-based survey. Lancet, 2011, 377: 63-73.</mixed-citation></citation-alternatives></ref><ref id="cit38"><label>38</label><citation-alternatives><mixed-citation xml:lang="ru">Curtin BF, Zarbalian Y, Flasar MH, von Rosenvinge E. Clostridium difficile -associated disease: Adherence with current guidelines at a tertiary medical center. World J Gastroenterol, 2013 December 14, 19(46): 8647-8651.</mixed-citation><mixed-citation xml:lang="en">Curtin BF, Zarbalian Y, Flasar MH, von Rosenvinge E. Clostridium difficile -associated disease: Adherence with current guidelines at a tertiary medical center. World J Gastroenterol, 2013 December 14, 19(46): 8647-8651.</mixed-citation></citation-alternatives></ref><ref id="cit39"><label>39</label><citation-alternatives><mixed-citation xml:lang="ru">Zilberberg MD, Tillotso GS, McDonald LC. Clostridium difficile Infections among Hospitalized Children, United States , 1997– 2006. Emer g. Infect. Dis., 2010 April, 16(4): 604–609.</mixed-citation><mixed-citation xml:lang="en">Zilberberg MD, Tillotso GS, McDonald LC. Clostridium difficile Infections among Hospitalized Children, United States , 1997– 2006. Emer g. Infect. Dis., 2010 April, 16(4): 604–609.</mixed-citation></citation-alternatives></ref><ref id="cit40"><label>40</label><citation-alternatives><mixed-citation xml:lang="ru">Cohen SH, Gerding DN, Johnson S, Kelly CP, Loo VG, McDonald LC, Pepin J, Wilcox MH, Society for Healthcare Epidemiology of America, Infectious Diseases Society of America. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Disases Society of America (IDSA). Infect Contr Hosp Epidem, 2010, 5: 431-455.</mixed-citation><mixed-citation xml:lang="en">Cohen SH, Gerding DN, Johnson S, Kelly CP, Loo VG, McDonald LC, Pepin J, Wilcox MH, Society for Healthcare Epidemiology of America, Infectious Diseases Society of America. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Healthcare Epidemiology of America (SHEA) and the Infectious Disases Society of America (IDSA). Infect Contr Hosp Epidem, 2010, 5: 431-455.</mixed-citation></citation-alternatives></ref><ref id="cit41"><label>41</label><citation-alternatives><mixed-citation xml:lang="ru">Elliott B, Reed R, Chang BJ, Riley TV. Bacteremia with a large clostridial toxin-negative, binary toxin-positive strain of Clostridium difficile. J. Anaerobe, 2009, 15: 249–251.</mixed-citation><mixed-citation xml:lang="en">Elliott B, Reed R, Chang BJ, Riley TV. Bacteremia with a large clostridial toxin-negative, binary toxin-positive strain of Clostridium difficile. J. Anaerobe, 2009, 15: 249–251.</mixed-citation></citation-alternatives></ref><ref id="cit42"><label>42</label><citation-alternatives><mixed-citation xml:lang="ru">Kociolek LK, Gerding DN. Clinical utility of laboratory detection of Clostridium difficile strain BI/ NAP1/027. J Clin Microbiol, 2016, 54(1): 19-24.</mixed-citation><mixed-citation xml:lang="en">Kociolek LK, Gerding DN. Clinical utility of laboratory detection of Clostridium difficile strain BI/ NAP1/027. J Clin Microbiol, 2016, 54(1): 19-24.</mixed-citation></citation-alternatives></ref><ref id="cit43"><label>43</label><citation-alternatives><mixed-citation xml:lang="ru">Vardakas KZ, Konstantelias AA, Loizidis G, Rafailidis PI, Falagas ME. Risk factors for development of Clostridium difficile infection due to BI/NAP1/027 strain: a meta-analysis. Int J Infect Dis, 2012, 16(11): 768-73.</mixed-citation><mixed-citation xml:lang="en">Vardakas KZ, Konstantelias AA, Loizidis G, Rafailidis PI, Falagas ME. Risk factors for development of Clostridium difficile infection due to BI/NAP1/027 strain: a meta-analysis. Int J Infect Dis, 2012, 16(11): 768-73.</mixed-citation></citation-alternatives></ref><ref id="cit44"><label>44</label><citation-alternatives><mixed-citation xml:lang="ru">Sartelli M, Malangoni MA, Abu-Zidan FM, Griffiths EA, di Bella S, et al. WSES guidelines for management of Clostridium difficile infection in surgical patients. World J Emerg Surg, 2015, 10: 38.</mixed-citation><mixed-citation xml:lang="en">Sartelli M, Malangoni MA, Abu-Zidan FM, Griffiths EA, di Bella S, et al. WSES guidelines for management of Clostridium difficile infection in surgical patients. World J Emerg Surg, 2015, 10: 38.</mixed-citation></citation-alternatives></ref><ref id="cit45"><label>45</label><citation-alternatives><mixed-citation xml:lang="ru">Surawicz СM, Brandt LJ, Binion DG, Ananthakrishnan AN, Curry SR, Gilligan PH, McFarland LV, Mellow M, Zuckerbraun BS. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol, 2013, 108(4): 478-98.</mixed-citation><mixed-citation xml:lang="en">Surawicz СM, Brandt LJ, Binion DG, Ananthakrishnan AN, Curry SR, Gilligan PH, McFarland LV, Mellow M, Zuckerbraun BS. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol, 2013, 108(4): 478-98.</mixed-citation></citation-alternatives></ref><ref id="cit46"><label>46</label><citation-alternatives><mixed-citation xml:lang="ru">Crobach MJT, Planche T, Eckert C, Barbut F, et al. European society of clinical microbiology and infectious diseases: Update of the diagnostic guidance document for Clostridium difficile infection. Clin Microbiol Infect, 2016, 22: 63-81.</mixed-citation><mixed-citation xml:lang="en">Crobach MJT, Planche T, Eckert C, Barbut F, et al. European society of clinical microbiology and infectious diseases: Update of the diagnostic guidance document for Clostridium difficile infection. Clin Microbiol Infect, 2016, 22: 63-81.</mixed-citation></citation-alternatives></ref><ref id="cit47"><label>47</label><citation-alternatives><mixed-citation xml:lang="ru">Peterson LR, Kelly JP, Nordbrock HA. Role of culture and toxin detection in laboratory testing for diagnosis of Clostridium difficile – associated diarrhea. Eur. J. Clin. Microbiol. Infect. Dis., 1996, 15: 330-6.</mixed-citation><mixed-citation xml:lang="en">Peterson LR, Kelly JP, Nordbrock HA. Role of culture and toxin detection in laboratory testing for diagnosis of Clostridium difficile – associated diarrhea. Eur. J. Clin. Microbiol. Infect. Dis., 1996, 15: 330-6.</mixed-citation></citation-alternatives></ref><ref id="cit48"><label>48</label><citation-alternatives><mixed-citation xml:lang="ru">Kachrimanidou M, Malisiovas N. Clostridium difficile Infection: A comprehensive review. Crit. Rev. Microbiol., 2011, 37(3): 178-187.</mixed-citation><mixed-citation xml:lang="en">Kachrimanidou M, Malisiovas N. Clostridium difficile Infection: A comprehensive review. Crit. Rev. Microbiol., 2011, 37(3): 178-187.</mixed-citation></citation-alternatives></ref><ref id="cit49"><label>49</label><citation-alternatives><mixed-citation xml:lang="ru">Qin J et al. A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature. Nature Publishing Group, 2012, 490(7418): 55-60.</mixed-citation><mixed-citation xml:lang="en">Qin J et al. A metagenome-wide association study of gut microbiota in type 2 diabetes. Nature. Nature Publishing Group, 2012, 490(7418): 55-60.</mixed-citation></citation-alternatives></ref><ref id="cit50"><label>50</label><citation-alternatives><mixed-citation xml:lang="ru">Алешкин В.А., Селькова Е.П., Миронов А.Ю., Гренкова Т.А., Шелыгин Ю.А. Лабораторная диагностика Clostridium difficileассоциированных диарей. Федеральные клинические рекомендации. 2017, c. 24.</mixed-citation><mixed-citation xml:lang="en">Алешкин В.А., Селькова Е.П., Миронов А.Ю., Гренкова Т.А., Шелыгин Ю.А. Лабораторная диагностика Clostridium difficileассоциированных диарей. Федеральные клинические рекомендации. 2017, c. 24.</mixed-citation></citation-alternatives></ref><ref id="cit51"><label>51</label><citation-alternatives><mixed-citation xml:lang="ru">Guarino А, Albano F, Ashkenazi S et al. European society for paediatric gastroenterology, hepatology, and nutrition/european society for paediatric infectious diseases evidencebased guidelines for the management of acute gastroenteritis in children in europe: executive summary. Journal of Pediatric Gastroenterology and Nutrition, 2008, 46(5): 619–621.</mixed-citation><mixed-citation xml:lang="en">Guarino А, Albano F, Ashkenazi S et al. European society for paediatric gastroenterology, hepatology, and nutrition/european society for paediatric infectious diseases evidencebased guidelines for the management of acute gastroenteritis in children in europe: executive summary. Journal of Pediatric Gastroenterology and Nutrition, 2008, 46(5): 619–621.</mixed-citation></citation-alternatives></ref></ref-list><fn-group><fn fn-type="conflict"><p>The authors declare that there are no conflicts of interest present.</p></fn></fn-group></back></article>
