临床荟萃

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艰难梭菌感染的临床特征与药物治疗进展

  

  1. 中国医学科学院北京协和医学院北京协和医院 消化内科,北京  100730
  • 出版日期:2018-05-05 发布日期:2018-05-29
  • 通讯作者: 通信作者:杨红,Email: hongy72@163.com
  • 作者简介:杨红,女,北京协和医院消化内科副教授,副主任医师。2004年毕业于北京协和医学院(博士学位),2006-2008年于美国国立卫生院从事博士后研究。目前担任中华医学会炎症性肠病学组委员兼秘书,中华医学会临床流行病学分会青年委员会副主任委员,北京医学会消化病分会青年委员会副主任委员。主持并参与多项国家自然基金课题。擅长炎症性肠病诊治及相关临床、基础、流行病学研究。

Progress of clinical characteristics and treatment of Clostrudium difficile  infection

  1. Department of Gastroenterology, Peking Union Medical College Hospital, Peking Union Medical College,
    Chinese Academy of Medical Sciences,Beijing 100730,China
  • Online:2018-05-05 Published:2018-05-29
  • Contact: Corrsponding author: Yang Hong,Email: hongy72@163.com

摘要: 艰难梭菌是医源性感染的常见病原菌之一,可引起抗生素相关腹泻,甚至诱发中毒性巨结肠、休克。其临床检测手段以针对毒素和产毒菌株的检测为主,联合检测时灵敏度、特异度更高。一旦确诊感染,首先需停用相关抗生素,推荐一线治疗方案包括万古霉素、非达霉素和甲硝唑,多次复发患者可考虑粪菌移植。

关键词: 梭菌感染, 诊断, 治疗

Abstract: Clostrudium difficile (CD) is a major cause of hospital acquired infection. It can cause antibioticassociated diarrhea and even induce toxic megacolon and shock. Symptoms of CD infection (CDI) range from mild diarrhea to lifethreatening pseudomembranous colitis, toxic megacolon, even death. The testing of CD  usually requires a multistep algorithm (ie, glutamate dehydrogenase plus toxin A and B enzyme immunoassays). The first therapeutic step of CDI is to discontinue the administration of the inciting antibiotic agents as soon as possible. And vancomycin, fidaxomicin and metronidazole are recommended as the most effective  therapies of CDI.  As to patients suffering from CDI recurrence,  fecal microbiota transplantation is recommended.

Key words: Clostrudium infections, diagnosis, treatment