gastro-jРоссийский журнал гастроэнтерологии, гепатологии, колопроктологииRussian Journal of Gastroenterology, Hepatology, Coloproctology1382-43762658-6673«Gastro» LLC10.22416/1382-4376-2023-33-2-19-33gastro-j-853Research ArticleОБЗОРЫREVIEWSСовременные подходы к диагностике и лечению Clostridioides difficile (C. difficile)-ассоциированной болезни у взрослых (Обзор литературы и резолюция Экспертного совета)Modern Approaches to the Diagnosis and treatment of Clostridioides difficile (C. difficile)-associated Disease in Adults (literature Review and Expert Council Resolution)https://orcid.org/0000-0002-6815-6015ИвашкинВ. Т.IvashkinV. T.

Ивашкин Владимир Трофимович — доктор медицинских наук, академик РАН, профессор, заведующий кафедрой пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Vladimir T. Ivashkin — Dr. Sci. (Med.), RAS Academician, Prof., Departmental Head, Department of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, N.V. Chief of Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

ivashkin_v_t@staff.sechenov.ruhttps://orcid.org/0000-0001-6114-564XМаевИ. В.MaevI. V.

Маев Игорь Вениаминович — доктор медицинских наук, академик РАН, профессор, заведующий кафедрой пропедевтики внутренних болезней и гастроэнтерологии.

127473, Москва, ул. Делегатская, д. 20, стр. 1

Igor V. Maev — Dr. Sci. (Med.), RAS Academician, Prof., Departmental Head, Department of Propaedeutics of Internal Diseases and Gastroenterology, A.I. Yevdokimov Moscow State University of Medicine and Dentistry.

127473, Moscow, Delegatskaya str., 20, bld. 1

igormaev@rambler.ruhttps://orcid.org/0000-0002-4007-7112АндреевД. Н.AndreevD. N.

Андреев Дмитрий Николаевич — кандидат медицинских наук, доцент кафедры пропедевтики внутренних болезней и гастроэнтерологии.

127473, Москва, ул. Делегатская, д. 20, стр. 1

Dmitry N. Andreev — Cand. Sci. (Med.), Assoc. Prof., Department of Internal Medicine Propaedeutics and Gastroenterology, Yevdokimov Moscow State University of Medicine and Dentistry.

127473, Moscow, Delegatskaya str., 20, bld. 1

dna-mit8@mail.ruhttps://orcid.org/0000-0002-0736-1269ГолощаповО. В.GoloshchapovO. V.

Голощапов Олег Валерьевич — кандидат медицинских наук, ассистент кафедры анестезиологии и реаниматологии ФГБОУ ВО «ПСПбГМУ им. ак. И.П. Павлова» МЗ РФ; заведующий ОРиИТ № 3 Научно-исследовательского института детской онкологии, гематологии и трансплантологии им. Р.М. Горбачевой.

197022, Санкт-Петербург, ул. Льва Толстого, д. 6-8

Oleg V. Goloshchapov — Cand. Sci. (Med.), Research Assistant, Department of anesthesiology and resuscitation, Pavlov University, St. Petersburg, Head of ICU No. 3, R.M. Gorbacheva Research Institute of Pediatric Oncology, Hematology and Transplantation.

197022, Saint Petersburg, L'va Tolstogo str., 6-8

golocht@yandex.ruДериновА. А.DerinovA. A.

Деринов Александр Александрович — кандидат медицинских наук, доцент кафедры хирургии.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Aleksandr A. Derinov — Cand. Sci. (Med.), Associate Professor; Department of Surgery, Institute of Clinical Medicine, Sechenov First Moscow State Medical University.

119435, Moscow, Pogodinskaya str., 1, bld. 1

alexandr.derinov@gmail.comhttps://orcid.org/0000-0002-6701-789XЗольниковаО. Ю.ZolnikovaO. Yu.

Зольникова Оксана Юрьевна — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Oksana Yu. Zolnikova — Dr. Sci. (Med.), Professor; Chair of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University); Chief External Gastroenterologist of the Central Federal District of the Russian Federation.

119435, Moscow, Pogodinskaya str., 1, bld. 1

zolnikova_o_yu@staff.sechenov.ruhttps://orcid.org/0000-0002-5699-541XИвашкинК. В.IvashkinK. V.

Ивашкин Константин Владимирович — доктор медицинских наук, доцент кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Konstantin V. Ivashkin — Cand. Sci. (Med.), Associate Professor; Chair of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

2135833@mail.ruhttps://orcid.org/0000-0001-8630-3616КиселёваО. Ю.KiselevaO. Yu.

Киселева Ольга Юрьевна — кандидат медицинских наук, заведующая отделением реанимации и интенсивной терапии Клиники пропедевтики внутренних болезней, гастроэнтерологии, гепатологии им. В.Х. Василенко.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Olga Yu. Kiseleva — Cand. Sci. (Med.); Head of the Department of Resuscitation and Intensive Care, Vasilenko Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

oyukisa@mail.ruhttps://orcid.org/0000-0001-5685-8784КирюхинА. П.KiryukhinA. P.

Кирюхин Андрей Павлович — кандидат медицинских наук, врач-эндоскопист отделения диагностической и лечебной эндоскопии Университетской клинической больницы № 2.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Andrey P. Kiryukhin — Cand. Sci. (Med.); Endoscopist, Department of Diagnostic and Therapeutic Endoscopy, University Clinical Hospital No 2, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

andresteam@mail.ruhttps://orcid.org/0000-0002-7330-6268ЛяшенкоО. С.LyashenkoO. S.

Ляшенко Ольга Сергеевна — врач-гастроэнтеролог гастроэнтерологического отделения клиники пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В.Х. Василенко.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Olga S. Lyashenko — Gastroenterologist, Department of Gastroenterology, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

olga-ljashenko@rambler.ruhttps://orcid.org/0000-0003-1312-120XПолуэктоваЕ. А.PoluektovaE. A.

Полуэктова Елена Александровна — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Elena A. Poluektova — Dr. Sci. (Med.), Prof., Chair of Internal Disease Propaedeutics, Gastroenterology and Hepatology; Gastroenterologist, Department of Chronic Intestinal and Pancreatic Diseases, Vasilenko Clinic of Internal Disease Propaedeutics, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

poluektova_e_a@staff.sechenov.ruhttps://orcid.org/0000-0001-5635-6100ТертычныйА. С.TertychnyyA. S.

Тертычный Александр Семёнович — доктор медицинских наук, профессор кафедры патологической анатомии имени академика А.И. Струкова.

119048, Москва, ул. Трубецкая, д. 8, стр. 2

Aleksandr S. Tertychnyy — Dr. Sci. (Med.), Professor; Strukov Department of Anatomical Pathology, Sechenov First Moscow State Medical University (Sechenov University).

119048, Moscow, Trubetskaya str., 8, bld. 2

tertychnyy_a_s@staff.sechenov.ruhttps://orcid.org/0000-0003-3362-2968ТрухмановА. С.TrukhmanovA. S.

Трухманов Александр Сергеевич — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии Института клинической медицины им. Н.В. Склифосовского.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Alexander S. Trukhmanov — Dr. Sci. (Med.), Professor; Chair of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

trukhmanov_a_s@staff.sechenov.ruhttps://orcid.org/0000-0001-5506-5555УльянинА. И.UlyaninA. I.

Ульянин Анатолий Игоревич — врач-гастроэнтеролог отделения хронических заболеваний кишечника и поджелудочной железы клиники пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В.Х. Василенко.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Anatoly I. Ulyanin — Gastroenterologist, Department of Chronic Intestinal and Pancreatic Diseases, Vasilenko Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

ulyanin_a_i@staff.sechenov.ruhttps://orcid.org/0000-0002-1395-9566ШептулинА. А.SheptulinA. A.

Шептулин Аркадий Александрович — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Arkadiy A. Sheptulin — Dr. Sci. (Med.), Professor; Chair of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

sheptulin_a_a@staff.sechenov.ruhttps://orcid.org/0000-0001-8148-2862ШифринО. С.ShifrinO. S.

Шифрин Олег Самуилович — доктор медицинских наук, профессор кафедры пропедевтики внутренних болезней, гастроэнтерологии и гепатологии Института клинической медицины им. Н.В. Склифосовского, заведующий отделением хронических заболеваний кишечника и поджелудочной железы клиники пропедевтики внутренних болезней, гастроэнтерологии и гепатологии им. В.Х. Василенко.

119435, Москва, ул. Погодинская, д. 1, стр. 1

Oleg S. Shifrin — Dr. Sci. (Med.), Professor; Chair of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology; Head, Department of Chronic Intestinal and Pancreatic Diseases, Vasilenko Clinic of Propaedeutics of Internal Diseases, Gastroenterology and Hepatology, Sechenov First Moscow State Medical University (Sechenov University).

119435, Moscow, Pogodinskaya str., 1, bld. 1

shifrin_o_s@staff.sechenov.ruФГАОУ ВО «Первый Московский государственный медицинский университет им. И.М. Сеченова» (Сеченовский Университет) Министерства здравоохранения Российской Федерации»РоссияI.M. Sechenov First Moscow State Medical University (Sechenov University)Russian FederationФГБОУ ВО «Московский государственный медико-стоматологический университет им. А.И. Евдокимова» Министерства здравоохранения Российской ФедерацииРоссияA.I. Yevdokimov Moscow State University of Medicine and DentistryRussian FederationФГБОУ ВО «Первый Санкт-Петербургский государственный медицинский университет им. академика И.П. Павлова»РоссияI.P. Pavlov First Saint Petersburg State Medical UniversityRussian Federation2023280420233321933Copyright © Ивашкин В.Т., Маев И.В., Андреев Д.Н., Голощапов О.В., Деринов А.А., Зольникова О.Ю., Ивашкин К.В., Киселёва О.Ю., Кирюхин А.П., Ляшенко О.С., Полуэктова Е.А., Тертычный А.С., Трухманов А.С., Ульянин А.И., Шептулин А.А., Шифрин О.С., 20232023Ивашкин В.Т., Маев И.В., Андреев Д.Н., Голощапов О.В., Деринов А.А., Зольникова О.Ю., Ивашкин К.В., Киселёва О.Ю., Кирюхин А.П., Ляшенко О.С., Полуэктова Е.А., Тертычный А.С., Трухманов А.С., Ульянин А.И., Шептулин А.А., Шифрин О.С.Ivashkin V.T., Maev I.V., Andreev D.N., Goloshchapov O.V., Derinov A.A., Zolnikova O.Y., Ivashkin K.V., Kiseleva O.Y., Kiryukhin A.P., Lyashenko O.S., Poluektova E.A., Tertychnyy A.S., Trukhmanov A.S., Ulyanin A.I., Sheptulin A.A., Shifrin O.S.Данная работа распространяется под лицензией Creative Commons Attribution 4.0.This work is licensed under a Creative Commons Attribution 4.0 License.https://www.gastro-j.ru/jour/article/view/853Цель публикации

Цель публикации. Рассмотреть современные подходы к диагностике и лечению C. difficile-ассоциированной болезни у взрослых и представить материалы Экспертного совета, который состоялся 25 марта 2023 г. в Москве.

Основные положения

Основные положения. C. difficile является наиболее значимой нозокомиальной инфекцией, споры которой также широко представлены в окружающей среде. Нарушение состава микробиоты, в первую очередь при приеме антибактериальных препаратов, является ключевым этапом в развитии C. difficile-ассоциированной болезни. Диагностика инфекции должна проводиться только у пациентов с диареей, при этом целесообразно использовать не менее двух лабораторных методов. Препаратом выбора для первой линии лечения служит ванкомицин. В случае неэффективности консервативного лечения, а также у пациентов с рецидивирующей клостридиальной инфекцией целесообразно рассмотреть вопрос о проведении трансплантации фекальной микробиоты. Пробиотический штамм Saccharomyces boulardii CNCM I-745 оказывает прямое ингибирующее действие на токсин А C. difficile, способствует нормализации состава кишечной микробиоты, а также уменьшению воспалительной реакции в слизистой оболочке толстой кишки при колонизации токсигенным штаммом C. difficile.

Выводы

Выводы. Добавление пробиотического штамма Saccharomyces boulardii CNCM I-745 на фоне антибактериальной терапии способствует как первичной, так и вторичной профилактике C. difficile-ассоциированной болезни.

Aim

Aim: to review the modern approaches to the diagnosis and treatment of C. difficile-associated disease in adults and present the resolution of the Expert Council held on March 25, 2023 in Moscow.

General provisions

General provisions. C. difficile is the most important nosocomial pathogen which spores are also commonly found in the environment. Microbiota impairment, primarily due to the use of antibacterial drugs, is a key stage in the development of C. difficile-associated disease. A search for an infection should be carried out only in patients with diarrhea, and it is advisable to use at least 2 laboratory methods. The drug of choice for first-line treatment is vancomycin. If drug treatment is ineffective or the patient has recurrent clostridial infection, fecal microbiota transplantation should be considered. The probiotic strain Saccharomyces boulardii CNCM I-745 has a direct inhibitory effect on C. difficile toxin A, promotes normalization of the intestinal microbiota composition, and decreases the inflammatory reaction in colonic mucosa colonized with a toxigenic strain of C. difficile.

Conclusions

Conclusions. Addition of the probiotic strain Saccharomyces boulardii CNCM I-745 to antibacterial therapy promotes both primary and secondary prevention of C. difficile-associated disease.

кишечная микробиотаантибиотикидиареяC. difficileпсевдомембранозный колитвидеоколоноскопияфекальная трансплантацияпробиотикиSaccharomyces boulardii CNCM I-745intestinal microbiotaantibioticsdiarrheaC. difficilepseudomembranous colitisvideo colonoscopyfecal transplantationprobioticsSaccharomyces boulardii CNCM I-745Экспертный совет состоялся при организационной поддержке фармацевтической компании «Биокодекс».The Expert Council was held with the organizational support of the pharmaceutical company Biocodex.ReferencesChang L.L., Allegretti J., Skinner A.M., Dubberke E.R. Oral Vancomycin as Secondary Prophylaxis for Prevention of Recurrent Clostridioides difficile Infection. N Engl J Med. 2023;388(7):654-6. DOI: 10.1056/NEJMcl-de2204692Chang L.L., Allegretti J., Skinner A.M., Dubberke E.R. Oral Vancomycin as Secondary Prophylaxis for Prevention of Recurrent Clostridioides difficile Infection. N Engl J Med. 2023;388(7):654-6. DOI: 10.1056/NEJMcl-de2204692Ивашкин В.Т., Ющук Н.Д., Маев И.В., Лапина Т.Л., Полуэктова Е.А., Шифрин О.С. и др. Рекомендации Российской гастроэнтерологической ассоциации по диагностике и лечению Clostridium difficile-ассоциированной болезни. Российский журнал гастроэнтерологии гепатологии колопроктологии. 2016;2б(5):56—65. DOI: 10.22416/1382-4376-2016-26-5-56-65Ivashkin V.T., Yushchuk N.D., Mayev I.V., Lapina T.L., Poluektova Ye.A., Shifrin O.S., et al. Diagnostics and treatment of Clostridium difficile-associated disease: Guidelines of the Russian gastroenterological association. Rus J Gastroenterol Hepatol Coloproctol. 2016;26(5):56— 65 (In Russ.). DOI: 10.22416/1382-4376-2016-26-5-56-65Fu Y., Luo Y., Grinspan A.M. Epidemiology of community-acquired and recurrent Clostridioides difficile infection. Therap Adv Gastroenterol. 2021;14:17562848211016248. DOI: 10.1177/17562848211016248Fu Y., Luo Y., Grinspan A.M. Epidemiology of community-acquired and recurrent Clostridioides difficile infection. Therap Adv Gastroenterol. 2021;14:17562848211016248. DOI: 10.1177/17562848211016248Singh T., Bedi P., Bumrah K., Singh J., Rai M., Seelam S. Updates in Treatment of Recurrent Clostridium difficile Infection. J Clin Med Res. 2019;11(7):465-71. DOI: 10.14740/jocmr3854Singh T., Bedi P., Bumrah K., Singh J., Rai M., Seelam S. Updates in Treatment of Recurrent Clostridium difficile Infection. J Clin Med Res. 2019;11(7):465-71. DOI: 10.14740/jocmr3854Kelly C.R., Fischer M., Allegretti J.R., LaPlante K., Stewart D.B., Limketkai B.N., Stollman N.H. ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections. Am J Gastroenterol. 2021;116(6):1124-47. DOI: 10.14309/ajg.0000000000001278. Erratum in: Am J Gastroenterol. 2022 Feb 1;117(2):358.Kelly C.R., Fischer M., Allegretti J.R., LaPlante K., Stewart D.B., Limketkai B.N., Stollman N.H. ACG Clinical Guidelines: Prevention, Diagnosis, and Treatment of Clostridioides difficile Infections. Am J Gastroenterol. 2021;116(6):1124-47. DOI: 10.14309/ajg.0000000000001278. Erratum in: Am J Gastroenterol. 2022 Feb 1;117(2):358.Van Hise N.W., Bryant A.M., Hennessey E.K., Crannage A.J., Khoury J.A., et al. Efficacy of Oral Vancomycin in Preventing Recurrent Clostridium difficile Infection in Patients Treated With Systemic Antimicrobial Agents. Clin Infect Dis. 2016;63(5):651-3. DOI: 10.1093/cid/ciw401Van Hise N.W., Bryant A.M., Hennessey E.K., Crannage A.J., Khoury J.A., et al. Efficacy of Oral Vancomycin in Preventing Recurrent Clostridium difficile Infection in Patients Treated With Systemic Antimicrobial Agents. Clin Infect Dis. 2016;63(5):651-3. DOI: 10.1093/cid/ciw401Carignan A., Poulin S., Martin P., Labbe A.C., Valiquette L., Al-Bachari H., et al. Efficacy of Secondary Prophylaxis With Vancomycin for Preventing Recurrent Clostridium difficile Infections. Am J Gastroenterol. 2016;111(12):1834-40. DOI: 10.1038/ajg.2016.417Carignan A., Poulin S., Martin P., Labbe A.C., Valiquette L., Al-Bachari H., et al. Efficacy of Secondary Prophylaxis With Vancomycin for Preventing Recurrent Clostridium difficile Infections. Am J Gastroenterol. 2016;111(12):1834-40. DOI: 10.1038/ajg.2016.417Babar S., El Kurdi B., El Iskandarani M., Haddad I., Imam Z., Alomari M., et al. Oral vancomycin prophylaxis for the prevention of Clostridium difficile infection: A systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2020;41(11):1302-9. DOI: 10.1017/ice.2020.277Babar S., El Kurdi B., El Iskandarani M., Haddad I., Imam Z., Alomari M., et al. Oral vancomycin prophylaxis for the prevention of Clostridium difficile infection: A systematic review and meta-analysis. Infect Control Hosp Epidemiol. 2020;41(11):1302-9. DOI: 10.1017/ice.2020.277Palleja A., Mikkelsen K.H., Forslund S.K., Kashani A., Allin K.H., Nielsen T., et al. Recovery of gut microbiota of healthy adults following antibiotic exposure. Nat Microbiol. 2018;3(11):1255-65. DOI: 10.1038/s41564-018-0257-9Palleja A., Mikkelsen K.H., Forslund S.K., Kashani A., Allin K.H., Nielsen T., et al. Recovery of gut microbiota of healthy adults following antibiotic exposure. Nat Microbiol. 2018;3(11):1255-65. DOI: 10.1038/s41564-018-0257-9Schubert A.M., Sinani H., Schloss P.D. Antibiotic-Induced Alterations of the Murine Gut Microbiota and Subsequent Effects on Colonization Resistance against Clostridium difficile. mBio. 2015;6(4):e00974. DOI: 10.1128/mBio.00974-15Schubert A.M., Sinani H., Schloss P.D. Antibiotic-Induced Alterations of the Murine Gut Microbiota and Subsequent Effects on Colonization Resistance against Clostridium difficile. mBio. 2015;6(4):e00974. DOI: 10.1128/mBio.00974-15Martinez E., Taminiau B., Rodriguez C., Daube G. Gut Microbiota Composition Associated with Clostridioides difficile Colonization and Infection. Pathogens. 2022;11(7):781. DOI: 10.3390/pathogens11070781Martinez E., Taminiau B., Rodriguez C., Daube G. Gut Microbiota Composition Associated with Clostridioides difficile Colonization and Infection. Pathogens. 2022;11(7):781. DOI: 10.3390/pathogens11070781Tomas M.E., Mana T.S.C., Wilson B.M., Nerandzic M.M., Joussef-Pina S., Quinones-Mateu M.E., Donskey C.J. Tapering Courses of Oral Vancomycin Induce Persistent Disruption of the Microbiota That Provide Colonization Resistance to Clostridium difficile and Vancomycin-Resistant Enterococci in Mice. Antimicrob Agents Chemother. 2018;62(5):e02237-17. DOI: 10.1128/AAC.02237-17Tomas M.E., Mana T.S.C., Wilson B.M., Nerandzic M.M., Joussef-Pina S., Quinones-Mateu M.E., Donskey C.J. Tapering Courses of Oral Vancomycin Induce Persistent Disruption of the Microbiota That Provide Colonization Resistance to Clostridium difficile and Vancomycin-Resistant Enterococci in Mice. Antimicrob Agents Chemother. 2018;62(5):e02237-17. DOI: 10.1128/AAC.02237-17Lawler A.J., Lambert P.A., Worthington T. A Revised Understanding of Clostridioides difficile Spore Germination. Trends Microbiol. 2020;28(9):744-52. DOI: 10.1016/j.tim.2020.03.004Lawler A.J., Lambert P.A., Worthington T. A Revised Understanding of Clostridioides difficile Spore Germination. Trends Microbiol. 2020;28(9):744-52. DOI: 10.1016/j.tim.2020.03.004Crobach M.T.J., Vernon J.J, Loo V.G., Kong L.Y., Pechine S., Wilcox M.H., Kuijpera E.J. Understanding Clostridium difficile Colonization. Clin Microbiol Rev. 2018;31(2):e00021-17. DOI: 10.1128/CMR.00021-17Crobach M.T.J., Vernon J.J, Loo V.G., Kong L.Y., Pechine S., Wilcox M.H., Kuijpera E.J. Understanding Clostridium difficile Colonization. Clin Microbiol Rev. 2018;31(2):e00021-17. DOI: 10.1128/CMR.00021-17Moono P., Lim S.C., Thomas V. Riley High prevalence of toxigenic Clostridium difficile in public space lawns in Western Australia. Sci Rep. 2017;7:41196. DOI: 10.1038/srep41196Moono P., Lim S.C., Thomas V. Riley High prevalence of toxigenic Clostridium difficile in public space lawns in Western Australia. Sci Rep. 2017;7:41196. DOI: 10.1038/srep41196Xu C., Weese J.S., Flemming C., Odumeru J., Warriner K. Fate of Clostridium difficile during wastewater treatment and incidence in Southern Ontario watersheds. J Appl Microbiol. 2014;117(3):891-904. DOI: 10.1111/jam.12575Xu C., Weese J.S., Flemming C., Odumeru J., Warriner K. Fate of Clostridium difficile during wastewater treatment and incidence in Southern Ontario watersheds. J Appl Microbiol. 2014;117(3):891-904. DOI: 10.1111/jam.12575Knetsch C.W., Connor T.R., Mutreja A., van Dorp S.M., Sanders I.M., Browne H.P., et al. Whole genome sequencing reveals potential spread of Clostridium difficile between humans and farm animals in the Netherlands, 2002 to 2011. Euro Surveill. 2014;19(45):20954. DOI: 10.2807/1560-7917.es2014.19.45.20954Knetsch C.W., Connor T.R., Mutreja A., van Dorp S.M., Sanders I.M., Browne H.P., et al. Whole genome sequencing reveals potential spread of Clostridium difficile between humans and farm animals in the Netherlands, 2002 to 2011. Euro Surveill. 2014;19(45):20954. DOI: 10.2807/1560-7917.es2014.19.45.20954Knight D.R., Squire M.M., Collins D.A., Riley T.V. Genome Analysis of Clostridium difficile PCR Ribotype 014 Lineage in Australian Pigs and Humans Reveals a Diverse Genetic Repertoire and Signatures of Long-Range Interspecies Transmission. Front Microbiol. 2017;7:2138. DOI: 10.3389/fmicb.2016.02138Knight D.R., Squire M.M., Collins D.A., Riley T.V. Genome Analysis of Clostridium difficile PCR Ribotype 014 Lineage in Australian Pigs and Humans Reveals a Diverse Genetic Repertoire and Signatures of Long-Range Interspecies Transmission. Front Microbiol. 2017;7:2138. DOI: 10.3389/fmicb.2016.02138Loo V.G., Brassard P., Miller M.A. Household Transmission of Clostridium difficile to Family Members and Domestic Pets. Infect Control Hosp Epidemiol. 2016;37(11):1342-8. DOI: 10.1017/ice.2016.178Loo V.G., Brassard P., Miller M.A. Household Transmission of Clostridium difficile to Family Members and Domestic Pets. Infect Control Hosp Epidemiol. 2016;37(11):1342-8. DOI: 10.1017/ice.2016.178Kordus S.L., Thomas A.K., Lacy D.B. Clostridioides difficile toxins: mechanisms of action and antitoxin therapeutics. Nat Rev Microbiol. 2022;20(5):285—98. DOI: 10.1038/s41579-021-00660-2Kordus S.L., Thomas A.K., Lacy D.B. Clostridioides difficile toxins: mechanisms of action and antitoxin therapeutics. Nat Rev Microbiol. 2022;20(5):285—98. DOI: 10.1038/s41579-021-00660-2Mullish B.H., Allegretti J.R. The contribution of bile acid metabolism to the pathogenesis of Clostridioides difficile infection. Therap Adv Gastroenterol. 2021;14:17562848211017725. DOI: 10.1177/17562848211017725Mullish B.H., Allegretti J.R. The contribution of bile acid metabolism to the pathogenesis of Clostridioides difficile infec-tion. Therap Adv Gastroenterol. 2021;14:17562848211017725. DOI: 10.1177/17562848211017725Semenyuk E.G., Poroyko V.A., Johnston P.F., Jones S.E., Knight K.L, Gerding D.N., Driks A. Analysis of Bacterial Communities during Clostridium difficile Infection in the Mouse. Infect Immun. 2015;83(11):4383—91. DOI: 10.1128/IAI.00145-15Semenyuk E.G., Poroyko V.A., Johnston P.F., Jones S.E., Knight K.L, Gerding D.N., Driks A. Analysis of Bacterial Communities during Clostridium difficile Infection in the Mouse. Infect Immun. 2015;83(11):4383—91. DOI: 10.1128/IAI.00145-15Ouyang Z.R., Niu X.R., Wang W.G., Zhao J.H. The role of short-chain fatty acids in Clostridioides difficile infection: A review. Anaerobe. 2022;75:102585. DOI: 10.1016/j.anaerobe.2022.102585Ouyang Z.R., Niu X.R., Wang W.G., Zhao J.H. The role of short-chain fatty acids in Clostridioides difficile infection: A review. Anaerobe. 2022;75:102585. DOI: 10.1016/j.anaerobe.2022.102585Hernandez Del Pino R.E., Barbero A.M., Espanol L.A., Morro L.S., Pasquinelli V. The adaptive immune response to Clostridioides difficile: A tricky balance between immunoprotection and immunopathogenesis. J Leukoc Biol. 2021;109(1):195-210. DOI: 1O.1002/JLB.4VMR072O-201RHernandez Del Pino R.E., Barbero A.M., Espanol L.A., Morro L.S., Pasquinelli V. The adaptive immune response to Clostridioides difficile: A tricky balance between immunoprotection and immunopathogenesis. J Leukoc Biol. 2021;109(1):195-210. DOI: 1O.1002/JLB.4VMR072O-201RKhurana S., Kahl A., Yu K., DuPont A.W. Recent advances in the treatment of Clostridioides difficile infection: the ever-changing guidelines. Fac Rev. 2020;9:13. DOI: 10.12703/b/9-13Khurana S., Kahl A., Yu K., DuPont A.W. Recent advances in the treatment of Clostridioides difficile infection: the ever-changing guidelines. Fac Rev. 2020;9:13. DOI: 10.12703/b/9-13Kukla M., Adrych K., Dobrowolska A., Mach T., Regula J., Rydzewska G. Guidelines for Clostridium difficile infection in adults. Gastroenterology Rev. 2020;15(1):1-21. DOI: 10.5114/pg.2020.93629Kukla M., Adrych K., Dobrowolska A., Mach T., Regula J., Rydzewska G. Guidelines for Clostridium difficile infection in adults. Gastroenterology Rev. 2020;15(1):1-21. DOI: 10.5114/pg.2020.93629Czepiel J., Drozdz M., Pituch H., Kuijper E.J., Perucki W., Mielimonka A., et al. Clostridium difficile infection: review. Eur J Clin Microbiol Infect Dis. 2019;38(7):1211-21. DOI: 10.1007/s10096-019-03539-6Czepiel J., Drozdz M., Pituch H., Kuijper E.J., Perucki W., Mielimonka A., et al. Clostridium difficile infection: review. Eur J Clin Microbiol Infect Dis. 2019;38(7):1211-21. DOI: 10.1007/s10096-019-03539-6McDonald L.C., Gerding D.N., Johnson S., Bakken J.S., Carroll K.C,, Coffin S.E., et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1-48. DOI: 10.1093/cid/ciy149McDonald L.C., Gerding D.N., Johnson S., Bakken J.S., Carroll K.C,, Coffin S.E., et al. Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66(7):e1-48. DOI: 10.1093/cid/ciy149Baker S.J., Chu D.I. Physical, Laboratory, Radiographic, and Endoscopic Workup for Clostridium difficile Colitis. Clin Colon Rectal Surg. 2020;33(2):82-6. DOI: 10.1055/s-0039-3400474Baker S.J., Chu D.I. Physical, Laboratory, Radiographic, and Endoscopic Workup for Clostridium difficile Colitis. Clin Colon Rectal Surg. 2020;33(2):82-6. DOI: 10.1055/s-0039-3400474Tagliaferri A.R., Murray K., Michael P. A Case of Pseudomembranous Colitis of Unknown Etiology. Cureus. 2022;14(2):e21914. DOI: 10.7759/cureus.21914Tagliaferri A.R., Murray K., Michael P. A Case of Pseudomembranous Colitis of Unknown Etiology. Cureus. 2022;14(2):e21914. DOI: 10.7759/cureus.21914Chandrasekaran R., Lacy D.B. The role of toxins in Clostridium difficile infection. FEMS Microbiol Rev. 2017;41(6):723-50. DOI: 10.1093/femsre/fux048Chandrasekaran R., Lacy D.B. The role of toxins in Clostridium difficile infection. FEMS Microbiol Rev. 2017;41(6):723-50. DOI: 10.1093/femsre/fux048Abdul J.S., Sundaramurthi S., Elamurugan T.P., Goneppanavar M., Nelamangala R.V.P. An Unusual Presentation of Pseudomembranous Colitis. Cureus. 2019;11(4):e4570. DOI: 10.7759/cureus.4570Abdul J.S., Sundaramurthi S., Elamurugan T.P., Goneppanavar M., Nelamangala R.V.P. An Unusual Presentation of Pseudomembranous Colitis. Cureus. 2019;11(4):e4570. DOI: 10.7759/cureus.4570Talbot I., Price A., Salto-Tellez M. Biopsy Pathology in Colorectal Disease. 2nd ed. London, CRS Press; 2006. DOI: 10.1201/b13363Talbot I., Price A., Salto-Tellez M. Biopsy Pathology in Colorectal Disease. 2nd ed. London, CRS Press; 2006. DOI: 10.1201/b13363Olofinlade O., Chiang C. Cytomegalovirus infection as a cause of pseudomembrane colitis: a report of four cases. J Clin Gastroenterol. 2001;32(1):82-4. DOI: 10.1097/00004836-200101000-00019Olofinlade O., Chiang C. Cytomegalovirus infection as a cause of pseudomembrane colitis: a report of four cases. J Clin Gastroenterol. 2001;32(1):82-4. DOI: 10.1097/00004836-200101000-00019Аруин Л.И., Капуллер Л.Л., Исаков В.А. Морфологическая диагностика болезней желудка и кишечника. М.: Триада-Х, 1998.Аруин Л.И., Капуллер Л.Л., Исаков В.А. Морфологическая диагностика болезней желудка и кишечника. М.: Триада-Х, 1998.Cerilli L.A., Greenson J.K. The differential diagnosis of colitis in endoscopic biopsy specimens: a review article. Arch Pathol Lab Med. 2012;136(8):854-64. DOI: 10.5858/arpa.2012-0205-RACerilli L.A., Greenson J.K. The differential diagnosis of colitis in endoscopic biopsy specimens: a review article. Arch Pathol Lab Med. 2012;136(8):854-64. DOI: 10.5858/arpa.2012-0205-RAKwon J.H., Reske K.A., Hink T., Burnham C.A.D., Dubberke E.R. Evaluation of Correlation between Pretest Probability for Clostridium difficile Infection and Clostridium difficile Enzyme Immunoassay Results. J Clin Microbiol. 2017;55(2):596-605. DOI: 10.1128/JCM.02126-16Kwon J.H., Reske K.A., Hink T., Burnham C.A.D., Dubberke E.R. Evaluation of Correlation between Pretest Probability for Clostridium difficile Infection and Clostridium difficile Enzyme Immunoassay Results. J Clin Microbiol. 2017;55(2):596-605. DOI: 10.1128/JCM.02126-16Johnson S., Lavergne V., Skinner A.M., Gonzales-Luna A.J., Garey K.W., Kelly C.P., Wilcox M.H. Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults. Clin Infect Dis. 2021;73(5):e1029-44. DOI: 10.1093/cid/ciab549Johnson S., Lavergne V., Skinner A.M., Gonzales-Luna A.J., Garey K.W., Kelly C.P., Wilcox M.H. Clinical Practice Guideline by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA): 2021 Focused Update Guidelines on Management of Clostridioides difficile Infection in Adults. Clin Infect Dis. 2021;73(5):e1029-44. DOI: 10.1093/cid/ciab549Guh A.Y., Kutty P.K. Clostridioides difficile Infection. Ann Intern Med. 2018;169(7):ITC49-64. DOI: 10.7326/AITC201810020Guh A.Y., Kutty P.K. Clostridioides difficile Infection. Ann Intern Med. 2018;169(7):ITC49-64. DOI: 10.7326/AITC201810020Nelson R.L., Suda K.J., Evans C.T. Antibiotic treatment for Clostridium difficile-associated diarrhoea in adults. Cochrane Database Syst Rev. 2017;3(3):CD004610. DOI: 10.1002/14651858.CD004610.pub5Nelson R.L., Suda K.J., Evans C.T. Antibiotic treatment for Clostridium difficile-associated diarrhoea in adults. Cochrane Database Syst Rev. 2017;3(3):CD004610. DOI: 10.1002/14651858.CD004610.pub5Johnson S., Louie T.G., Gerding D.N., Cornely O.A., Chasan-Taber S., Fitts D., Gelone S.P., Broom C., Davidson D.M. Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis. 2014;59(3):345-54. DOI: 10.1093/cid/ciu313Johnson S., Louie T.G., Gerding D.N., Cornely O.A., Chasan-Taber S., Fitts D., Gelone S.P., Broom C., Davidson D.M. Vancomycin, metronidazole, or tolevamer for Clostridium difficile infection: results from two multinational, randomized, controlled trials. Clin Infect Dis. 2014;59(3):345-54. DOI: 10.1093/cid/ciu313Baunwall S.M.D., Lee M.M, Eriksen M.K., Mullish B.H., Marchesi J.R., Dahlerup J.F., Hvas C.L. Faecal microbiota transplantation for recurrent Clostridioides difficile infection: An updated systematic review and meta-analysis. EClinicalMedicine. 2020;29-30:100642. DOI: 10.1016/j.eclinm.2020.100642Baunwall S.M.D., Lee M.M, Eriksen M.K., Mullish B.H., Marchesi J.R., Dahlerup J.F., Hvas C.L. Faecal microbiota transplantation for recurrent Clostridioides difficile infection: An updated systematic review and meta-analysis. EClinicalMedicine. 2020;29-30:100642. DOI: 10.1016/j.eclinm.2020.100642Rapoport E.A., Baig M., Puli S.R. Adverse events in fecal microbiota transplantation: a systematic review and meta-analysis. Ann Gastroenterol. 2022;35(2):150-63. DOI: 10.20524/aog.2022.0695Rapoport E.A., Baig M., Puli S.R. Adverse events in fecal microbiota transplantation: a systematic review and meta-analysis. Ann Gastroenterol. 2022;35(2):150-63. DOI: 10.20524/aog.2022.0695McFarland L.V., Evans C.T., Goldstein E.J.C. Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2018;5:124. DOI: 10.3389/fmed.2018.00124McFarland L.V., Evans C.T., Goldstein E.J.C. Strain-Specificity and Disease-Specificity of Probiotic Efficacy: A Systematic Review and Meta-Analysis. Front Med (Lausanne). 2018;5:124. DOI: 10.3389/fmed.2018.00124Raseen T., Devvrat Y., Muhammad Waqas T., Kanika S., Darrell P., Sahil K. S136 Efficacy of Saccharomyces boulardii for Prevention of Clostridioides difficile Infection: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2021;116(1):S59-60. DOI: 10.14309/01.ajg.0000773016.43460.ebRaseen T., Devvrat Y., Muhammad Waqas T., Kanika S., Darrell P., Sahil K. S136 Efficacy of Saccharomyces boulardii for Prevention of Clostridioides difficile Infection: A Systematic Review and Meta-Analysis. Am J Gastroenterol. 2021;116(1):S59-60. DOI: 10.14309/01.ajg.0000773016.43460.ebDuan J., Meng X., Liu S., Zhou P., Zeng C., Fu C., et al. Gut Microbiota Composition Associated With Clostridium difficile-Positive Diarrhea and C. difficile Type in ICU Patients. Front Cell Infect Microbiol. 2020;10:190. DOI: 10.3389/fcimb.2020.00190Duan J., Meng X., Liu S., Zhou P., Zeng C., Fu C., et al. Gut Microbiota Composition Associated With Clostridium difficile-Positive Diarrhea and C. difficile Type in ICU Patients. Front Cell Infect Microbiol. 2020;10:190. DOI: 10.3389/fcimb.2020.00190Berkell M., Mysara M., Xavier B.B., Werkhoven C.H., Monsieurs P., Lammens C., et al. Microbiota-based markers predictive of development of Clostridioides difficile infection. Nat Commun. 2021;12(1):2241. DOI: 10.1038/s41467-021-22302-0Berkell M., Mysara M., Xavier B.B., Werkhoven C.H., Monsieurs P., Lammens C., et al. Microbiota-based markers predictive of development of Clostridioides difficile infection. Nat Commun. 2021;12(1):2241. DOI: 10.1038/s41467-021-22302-0Goldenberg J.Z., Yap C., Lytvyn L., Lo C.K., Beardsley J., Mertz D., Johnston B.C. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Sys Rev. 2017;12(12):CD006095. DOI: 10.1002/14651858.CD006095.pub4Goldenberg J.Z., Yap C., Lytvyn L., Lo C.K., Beardsley J., Mertz D., Johnston B.C. Probiotics for the prevention of Clostridium difficile-associated diarrhea in adults and children. Cochrane Database Sys Rev. 2017;12(12):CD006095. DOI: 10.1002/14651858.CD006095.pub4Lau C.S.M., Chamberlain R.S. Probiotics are effective at preventing Clostridium difficile-associated diarrhea: a systematic review and meta-analysis. Int J Gen Med. 2016;9:27-37. DOI: 10.2147/IJGM.S98280Lau C.S.M., Chamberlain R.S. Probiotics are effective at preventing Clostridium difficile-associated diarrhea: a systematic review and meta-analysis. Int J Gen Med. 2016;9:27-37. DOI: 10.2147/IJGM.S98280Shen N.T., Maw A., Tmanova L.L., Pino A., Ancy K., Crawford C.V., et al. Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis. Gastroenterology. 2017;152(8):1889-900.e9. DOI: 10.1053/j.gastro.2017.02.003Shen N.T., Maw A., Tmanova L.L., Pino A., Ancy K., Crawford C.V., et al. Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis. Gastroenterology. 2017;152(8):1889-900.e9. DOI: 10.1053/j.gastro.2017.02.003Madoff S.E., Urquiaga M., Alonso C.D., Kelly C.P. Prevention of recurrent Clostridioides difficile infection: A systematic review of randomized controlled trials. Anaerobe. 2020;61:102098. DOI: 10.1016/j.anaerobe.2019.102098Madoff S.E., Urquiaga M., Alonso C.D., Kelly C.P. Prevention of recurrent Clostridioides difficile infection: A systematic review of randomized controlled trials. Anaerobe. 2020;61:102098. DOI: 10.1016/j.anaerobe.2019.102098Kazmierczak-Siedlecka K., Ruszkowski J., Fic M., Folwarski M., Makarewicz W. Saccharomyces boulardii CNCM I-745: A Non-bacterial Microorganism Used as Probiotic Agent in Supporting Treatment of Selected Diseases. Curr Microbiol. 2020 Sep;77(9):1987-96. DOI: 10.1007/s00284-020-02053-9Kazmierczak-Siedlecka K., Ruszkowski J., Fic M., Folwarski M., Makarewicz W. Saccharomyces boulardii CNCM I-745: A Non-bacterial Microorganism Used as Probiotic Agent in Supporting Treatment of Selected Diseases. Curr Microbiol. 2020 Sep;77(9):1987-96. DOI: 10.1007/s00284-020-02053-9Valdes-Varela L., Gueimonde M., Ruas-Madiedo P. Probiotics for Prevention and Treatment of Clostridium difficile Infection. Adv Exp Med Biol. 2018;1050:161-76. DOI: 10.1007/978-3-319-72799-8_10Valdes-Varela L., Gueimonde M., Ruas-Madiedo P. Probiotics for Prevention and Treatment of Clostridium difficile Infection. Adv Exp Med Biol. 2018;1050:161-76. DOI: 10.1007/978-3-319-72799-8_10Gaisawat M.B., MacPherson C.W., Tremblay J., Piano A., Iskandar M.M., Tompkins T.A., Kubow S. Probiotic Supplementation in a Clostridium difficile-Infected Gastrointestinal Model Is Associated with Restoring Metabolic Function of Microbiota. Microorganisms. 2020;8(1):60. DOI: 10.3390/microorganisms8010060Gaisawat M.B., MacPherson C.W., Tremblay J., Piano A., Iskandar M.M., Tompkins T.A., Kubow S. Probiotic Supplementation in a Clostridium difficile-Infected Gastrointestinal Model Is Associated with Restoring Metabolic Function of Microbiota. Microorganisms. 2020;8(1):60. DOI: 10.3390/microorganisms8010060Lacotte P.A., Simons A., Bouttier S., Malet-Villemagne J., Nicolas V., Janoir C. Inhibition of In Vitro Clostridioides difficile Biofilm Formation by the Probiotic Yeast Saccharomyces boulardii CNCM I-745 through Modification of the Extracellular Matrix Composition. Microorganisms. 2022;10(6):1082. DOI: 10.3390/microorganisms10061082Lacotte P.A., Simons A., Bouttier S., Malet-Villemagne J., Nicolas V., Janoir C. Inhibition of In Vitro Clostridioides difficile Biofilm Formation by the Probiotic Yeast Saccharomyces boulardii CNCM I-745 through Modification of the Extracellular Matrix Composition. Microorganisms. 2022;10(6):1082. DOI: 10.3390/microorganisms10061082Kelly C.P., Chong-Nguyen C., Palmieri L.J., Pallav K., Dowd S.E., Humbert L., et al. Saccharomyces boulardii CNCM I-745 modulates the fecal bile acids metabolism during antimicrobial therapy in healthy volunteers. Front Microbiol. 2019;10:336. DOI: 10.3389/fmicb.2019.00336Kelly C.P., Chong-Nguyen C., Palmieri L.J., Pallav K., Dowd S.E., Humbert L., et al. Saccharomyces boulardii CNCM I-745 modulates the fecal bile acids metabolism during antimicrobial therapy in healthy volunteers. Front Microbiol. 2019;10:336. DOI: 10.3389/fmicb.2019.00336Koon H.W., Su B., Xu C., Mussatto C.C., Tran D.H., Lee E.C., et al. Probiotic Saccharomyces boulardii CNCM I-745 prevents outbreak-associated Clostridium difficile-associated cecal inflammation in hamsters. Am J Physiol Gastrointest Liver Physiol. 2016;311(4):G610-23. DOI: 10.1152/ajpgi.00150.2016Koon H.W., Su B., Xu C., Mussatto C.C., Tran D.H., Lee E.C., et al. Probiotic Saccharomyces boulardii CNCM I-745 prevents outbreak-associated Clostridium difficile-associated cecal inflammation in hamsters. Am J Physiol Gastrointest Liver Physiol. 2016;311(4):G610-23. DOI: 10.1152/ajpgi.00150.2016Ивашкин В.Т., Абдулганиева Д.И., Алексеенко С.А., Горелов А.В., Захарова И.Н. и др. Практические рекомендации Научного сообщества по содействию клиническому изучению микробиома человека (НСОИМ) и Российской гастроэнтерологической ассоциации (РГА) по применению пробиотиков, пребиотиков, синбиотиков и обогащенных ими функциональных пищевых продуктов для лечения и профилактики заболеваний гастроэнтерологического профиля у детей и взрослых. Российский журнал гастроэнтерологии гепатологии колопроктологии. 2021;31(2):65-91. DOI: 10.22416/1382-4376-2021-31-2-65-91Ivashkin V.T., Maev I.V., Abdulganieva D.I., Alekseenko S.A., Gorelov A.V., Zakharova I.N., et al. Practical Recommendations of Scientific Society for the Study of Human Microbiome and the Russian Gastroenterological Association on Use of Probiotics, Prebiotics, Synbiotics and Functional Foods in Treatment and Prevention of Gastroenterological Diseases in Children and Adults. Rus J Gastroenterol Hepatol Coloproctol. 2021;31(2):65-91 (In Russ.). DOI: 10.22416/1382-4376-2021-31-2-65-91Cammarota G., Ianiro G., Tilg H., The European FMT Working Group, et al. European consensus conference on faecal microbiota transplantation in clinical practice. Gut. 2017;66:569-80. DOI: 10.1136/gutjnl-2016-313017Cammarota G., Ianiro G., Tilg H., The European FMT Working Group, et al. European consensus conference on faecal microbiota transplantation in clinical practice. Gut. 2017;66:569-80. DOI: 10.1136/gutjnl-2016-313017Голощапов О.В., Чухловин А.Б., Бакин Е.А., Станевич О.В., Клементьева Р.В., Щербаков А.А. и др. Трансплантация фекальной микробиоты при реакции «трансплантат против хозяина» у детей и взрослых: методы, клинические эффекты, безопасность. Терапевтический архив. 2020;92(7):43-54. DOI: 10.26442/00403660.2020.07.000773Goloshchapov O.V., Chukhlovin A.B., Bakin E.A., Stanevich O.V., Klementeva R.V., Shcherbakov A.A., et al. Fecal microbiota transplantation for graft-versus-host disease in children and adults: methods, clinical effects, safety. Terapevticheskiy arkhiv. 2020;92(7):43-54 (In Russ.). DOI: 10.26442/00403660.2020.07.000773Hvas C.L., J0rgensen S.M.D., J0rgensen S.P., Storgaard M., Lemming L., Hansen M.M., et al. Fecal Microbiota Transplantation Is Superior to Fidaxomicin for Treatment of Recurrent Clostridium difficile Infection. Gastroenterology. 2019;156(5):1324-32.e3. DOI: 10.1053/j.gastro.2018.12.019Hvas C.L., J0rgensen S.M.D., J0rgensen S.P., Storgaard M., Lemming L., Hansen M.M., et al. Fecal Microbiota Transplantation Is Superior to Fidaxomicin for Treatment of Recurrent Clostridium difficile Infection. Gastroenterology. 2019;156(5):1324-32.e3. DOI: 10.1053/j.gastro.2018.12.019Wang J.W., Kuo C.H., Kuo F.C., Wang Y.K., Hsu W.H., Yu F.J., et al. Fecal microbiota transplantation: Review and update. J Formos Med Assoc. 2019;118 (Suppl 1):S23-31. DOI: 10.1016/j.jfma.2018.08.011Wang J.W., Kuo C.H., Kuo F.C., Wang Y.K., Hsu W.H., Yu F.J., et al. Fecal microbiota transplantation: Review and update. J Formos Med Assoc. 2019;118 (Suppl 1):S23-31. DOI: 10.1016/j.jfma.2018.08.011Panchal P., Budree S., Scheeler A., Medina G., Seng M., Wong W.F., et al. Scaling Safe Access to Fecal Microbiota Transplantation: Past, Present, and Future. Curr Gastroenterol Rep. 2018;20(4):14. DOI: 10.1007/s11894-018-0619-8Panchal P., Budree S., Scheeler A., Medina G., Seng M., Wong W.F., et al. Scaling Safe Access to Fecal Microbiota Transplantation: Past, Present, and Future. Curr Gastroenterol Rep. 2018;20(4):14. DOI: 10.1007/s11894-018-0619-8Tkach S., Dorofeyev A., Kuzenko I., Boyko N., Falalyeyeva T., Boccuto L., et al. Current Status and Future Therapeutic Options for Fecal Microbiota Transplantation. Medicina (Kaunas). 2022;58(1):84. DOI: 10.3390/medicina58010084Tkach S., Dorofeyev A., Kuzenko I., Boyko N., Falalyeyeva T., Boccuto L., et al. Current Status and Future Therapeutic Options for Fecal Microbiota Transplantation. Medicina (Kaunas). 2022;58(1):84. DOI: 10.3390/medicina58010084Marcella C., Cui B., Kelly C.R., Ianiro G., Cammarota G., Zhang F. Systematic review: the global incidence of faecal microbiota transplantation-related adverse events from 2000 to 2020. Aliment Pharmacol Ther. 2021;53(1):33-42. DOI: 10.1111/apt.16148Marcella C., Cui B., Kelly C.R., Ianiro G., Cammarota G., Zhang F. Systematic review: the global incidence of faecal microbiota transplantation-related adverse events from 2000 to 2020. Aliment Pharmacol Ther. 2021;53(1):33-42. DOI: 10.1111/apt.16148

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