fcmedicineФундаментальная и клиническая медицинаFundamental and Clinical Medicine2500-07642542-0941КемГМУ10.23946/2500-0764-2025-10-3-15-23fcmedicine-1060Research ArticleЭПИДЕМИОЛОГИЯEPIDEMIOLOGYЭпидемиология и профилактика инфекции, обусловленной Clostridioides difficile у пациентов, перенесших панкреатодуоденальную резекцию (обзор литературы)Epidemiology and prevention of Clostridioides difficile infection in patients undergoing pancreatoduodenectomy (narrative review)https://orcid.org/0009-0000-7062-7085ГамовО. Г.GamovO. G.

Гамов Олег Геннадьевич, заместитель главного врача по санитарно-эпидемиологическому режиму 

ул. Рублевское предместье, д. 2, корп. 2, д. Глухово, г. о. Красногорск, Московская обл., 143421 

Dr. Oleg G. Gamov, MD, Deputy Chief Executive Officer on Disease Surveillance 

Rublyovskoye Predmestye Street, 2, Building 2, Glukhovo Village, Krasnogorsk Urban District, Moscow Region, 143421 

gamovog@mail.ruИльинская больницаРоссияIlyinskaya HospitalRussian Federation2025290920251031523Copyright © Гамов О.Г., 20252025Гамов О.Г.Gamov O.G.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://fcm.kemsmu.ru/jour/article/view/1060

Цель. Обобщение и анализ современных данных об эпидемиологических особенностях и мерах профилактики инфекции, обусловленной Clostridioides difficile, у пациентов, перенесших панкреатодуоденальную резекцию, с акцентом на факторы риска, частоту возникновения инфекции и стратегии снижения заболеваемости в послеоперационном периоде. Материалы и методы. Проведен поиск в базах данных MEDLINE, Embase, Scopus, Cochrane, PubMed, Google Scholar, а также в прямых и обратных ссылках на исследования, опубликованные в период между июнем 2005 г. и июнем 2025 г. Были включены систематические обзоры и мета-анализы, одноцентровые, многоцентровые, поперечные, наблюдательные, проспективные, когортные исследования, а также рандомизированные контролируемые испытания на русском и английском языках. Результаты. Установлено, что пациенты, перенесшие панкреатодуоденальную резекцию, находятся в группе высокого риска по развитию инфекции, обусловленной Clostridioides difficile вследствие сочетания ряда факторов. Отмечена высокая распространенность C. difficile в хирургических отделениях и связь с тяжелым течением, особенно при инфицировании гипервирулентными риботипами (например, 027). Заключение. Инфекция, обусловленная C. difficile, представляет серьезную угрозу для пациентов после панкреатодуоденальной резекции. Своевременная диагностика, контроль инфекции и рациональное использование антисекреторных и антибактериальных препаратов являются ключевыми мерами профилактики. Необходимы дальнейшие эпидемиологические и клинические исследования, направленные на уточнение факторов риска и разработку эффективных протоколов ведения таких пациентов.

Aim. To summarize and analyze current data on the epidemiological characteristics and preventive measures of Clostridioides difficile infection in patients after pancreatoduodenectomy, with a focus on risk factors, infection incidence, and strategies to reduce postoperative morbidity. Materials and Methods. A comprehensive literature search was conducted using MEDLINE, Embase, Scopus, Cochrane, PubMed, and Google Scholar databases, as well as through citation tracking of studies published between June 2005 and June 2025. The review included systematic reviews and meta-analyses, single- and multicenter studies, cross-sectional, observational, prospective, cohort studies, and randomized controlled trials in both Russian and English. Results. Patients who underwent pancreatoduodenectomy were found to be at high risk of developing Clostridioides difficile infection due to a combination of factors. High prevalence of C. difficile was noted in surgical departments, with severe disease particularly associated with hypervirulent ribotypes (e.g., 027). Conclusion. C. difficile infection poses a serious threat to patients after pancreatoduodenectomy. Timely diagnosis, strict infection control, and rational use of antisecretory and antibacterial agents are key preventive measures. Further epidemiological and clinical studies are needed to better define risk factors and to develop effective management protocols for these patients.

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The authors declare that there are no conflicts of interest present.