共查询到19条相似文献,搜索用时 156 毫秒
1.
基于表型特征、化学分类学及系统发育学等研究,艰难梭菌已被归入拟梭菌属,并重命名为艰难拟梭菌。 近年来,随着多重耐药艰难拟梭菌不断出现,导致抗生素治疗失效以及感染复发病例明显上升。 目前欧美部分国家已建立完善的艰难拟梭菌感染监控体系及相应的临床诊疗指南,但我国相关工作起步较晚。 同时,我国仍存在抗生素使用不规范甚至滥用等现象,造成艰难拟梭菌感染的防控及诊治面临较大挑战。 本研究主要介绍了艰难拟梭菌重命名及相关致病因子研究进展,为在国内修正和规范化使用“艰难拟梭菌”名称、推动国内艰难拟梭菌研究进程及致病机制研究等提供必要的参考依据。 相似文献
2.
3.
4.
艰难梭菌以芽孢的形式通过粪-口途径传播并定植于肠道,是院内感染性腹泻和抗生素相关性腹泻的主要病原菌之一。由于抗生素的滥用及高毒力菌株的暴发流行,艰难梭菌感染的发病率及严重程度日益增加,给临床诊疗带来严峻的挑战,成为全球公共卫生安全的焦点问题。本文对艰难梭菌感染诊断相关生物标志物和治疗的研究进展进行阐述,旨在为临床医生提供艰难梭菌感染的诊断和治疗基础。 相似文献
5.
黄海辉 《中国感染与化疗杂志》2011,11(6):424-425
艰难梭菌(Clostridium difficile)为革兰阳性厌氧产芽孢杆菌,是人类肠道中的正常菌群之一.艰难梭菌本身没有侵袭性,其中部分细菌(产毒株)可通过分泌毒素A、毒素B和(或)二元毒素从而引起抗生素相关性腹泻、结肠炎甚至致死性伪膜性肠炎,统称为艰难梭菌感染(Clostridium di ficile infection,CDI).艰难梭菌为医院获得感染性腹泻最主要的病原菌,在抗生素相关性腹泻病因中艰难梭菌亦占20%~30%;而伪膜性肠炎则几乎100%由艰难梭菌所致.肠道外CDI如败血症等则极为罕见.不仅仅是抗菌药物,其他影响肠道正常菌群平衡、降低艰难梭菌定植抵抗能力的因素,如老年、胃肠道手术、应用抗肿瘤药物、长期住院和免疫功能缺陷等均为CDI的危险因素. 相似文献
6.
艰难梭菌相关性腹泻研究进展 总被引:1,自引:0,他引:1
艰难梭菌(Clostridium difficile)是人类肠道中的正常菌群,使用抗菌药物后可导致该菌过度生长。1978年起认识到艰难梭菌与抗生素相关性腹泻有关。随着广谱抗菌药物的广泛应用,全球范围内艰难梭菌相关性腹泻(Clostridium difficile associated diarrhea,CDAD)的发生率不断增高。近年来发现CDAD可出现爆发流行,其流行株出现基因变异,产生毒素的能力增加,患者病死率增高,引起医学界的重视。以下对CDAD研究新进展作一综述。 相似文献
7.
艰难梭菌相关性腹泻的治疗和预防 总被引:1,自引:0,他引:1
刘杨 《中国感染与化疗杂志》2001,1(2):125-126
艰难梭菌是具有芽胞结构的革兰阳性厌氧杆菌 ,二十世纪九十年代以来成为最重要的医院感染的病原之一。近期的研究表明 ,艰难梭菌是肠道感染中第二位常见致病菌 ,仅次于弯曲菌属 ,易引起以发热、腹痛、水样泻及伪膜性肠炎为主要症状的艰难梭菌相关性腹泻 (Clostridiumdifficile associ ateddiarrhea ,CDAD)。在美国 ,艰难梭菌感染在抗生素相关性腹泻中占 10 %~ 2 0 %。不仅仅是抗菌药 ,其他影响肠道正常菌群 ,降低对艰难梭菌定殖抵抗的因素 ,如胃肠道术后、应用抗肿瘤药物、长期住院、免疫缺陷等… 相似文献
8.
目的通过对临床分离的8株产毒型艰难梭菌进行PCR分型以及抗生素敏感性分析,初步了解临床分离艰难梭菌的耐药情况,为临床用药提供参考依据。方法临床送检的粪便标本,经生化鉴定和毒素检测后,确定8株为产毒型艰难梭菌,分别采用PCR方法进行分型,并采用Etest方法测定8株艰难梭菌对氨比西林(AC)、克林霉素(CM)、甲硝唑(MZ)、万古霉素(VA)的最小抑菌浓度,并对耐药性进行初步分析。结果8株产毒型艰难梭菌中有5株属于同一型别,7株出现耐药;3株对AC耐药;7株对CM耐药;1株对MZ耐药;未检测到对VA耐药菌株。结论临床分离艰难梭菌耐药比例高,且存在多重耐药;临床应加强艰难梭菌及厌氧菌抗生素敏感性检测。 相似文献
9.
目的评估Xpert艰难梭菌检测系统的临床应用价值。方法选取43份腹泻粪便标本,采用厌氧培养法、VIDAS检测A/B毒素法和Xpert艰难梭菌检测系统检测艰难梭菌,以产毒培养法作为金标准对检测方法进行评价,并比较不同检测方法对临床标本检测结果的一致性。通过自配027型标准菌株模拟粪便标本,验证Xpert艰难梭菌检测系统筛选027型流行株的能力。结果以产毒培养法为金标准,Xpert艰难梭菌检测系统的敏感性和特异性分别为90.9%和93.8%,阳性和阴性预测值分别为83.3%和96.8%。与产毒培养法结果一致性检验Kappa值为0.822(P0.05),与VIDAS检测A/B毒素法结果一致性检验Kappa值为0.419(P0.05);027型标准菌株模拟粪便标本检测结果阳性并报告为027型。结论 Xpert艰难梭菌检测系统能够快速准确地检测粪便标本中的艰难梭菌相关基因,且能准确报告027型高产毒力菌株。 相似文献
10.
11.
Clostridium difficile is currently recognized as the most common cause of nosocomial infectious diarrhea in the nursing home setting. Data from the Centers for Disease Control and Prevention confirm that the incidence of C. difficile has doubled in recent years and accounts for approximately 3 million cases of diarrhea and colitis each year. Overall mortality associated with C. difficile infectious diarrhea is estimated to be 17% but is even higher in the older adult population. Older adults are at higher risk for this infection because of age-related changes in fecal flora and host defenses, as well as the presence of multiple comorbidities. Nursing staff, nurse practitioners, and physicians must become knowledgeable in the treatment and management of C. difficile before it reaches epidemic proportions. Diligent infection control practices, health care worker education, family education, and identification of new prevention and control strategies are vital to limiting its spread. 相似文献
12.
Karpa KD 《The Annals of pharmacotherapy》2007,41(7):1284-1287
Clostridium difficile diarrhea is an expensive, life-threatening infection associated with serious morbidity and mortality, even among previously healthy individuals. Relapses from the infection are common following standard antibiotic treatments, with 3-5% of patients who contract C. difficile diarrhea unable to discontinue vancomycin due to continual relapses. Such patients may have a focal immunodeficiency in which they fail to mount an immune response against C. difficile. For these individuals, antimicrobial therapies are unable to eradicate the microorganism because no antibiotics are capable of killing C. difficile spores. Although they are considered alternative medicine, probiotics have provided a safe and effective means of restoring gastrointestinal flora and alleviating diarrhea, particularly for individuals experiencing multiple relapses. 相似文献
13.
The clinical presentation of colitis associated with Clostridium difficile infection in immunosuppressed patients with acquired immunodeficiency syndrome (AIDS) has not been completely characterized. Previous reports suggest that these patients present with low blood leukocyte counts, consistent with the impaired myelopoiesis that can occur with human immunodeficiency virus (HIV) infection. In contrast, we describe the cases of two patients with colitis associated with C difficile infection who developed intense leukemoid reactions despite being in advanced stages of AIDS. To the best of our knowledge, these are the first described cases of leukemoid reaction associated with C difficile or other bacterial infection in AIDS patients. We review the literature on C difficile colitis in patients infected with HIV and suggest that severe C difficile infection should be considered in such patients presenting with leukemoid reaction and diarrhea. 相似文献
14.
艰难梭菌是一种专性厌氧革兰阳性芽孢杆菌,一般认为是环境和人类肠道中的正常菌群。过度应用抗生素、免疫抑制剂或化疗药物使耐药的艰难梭菌产毒株过度繁殖并释放毒素是导致艰难梭菌感染(Clostridioides difficile infection, CDI)的主要因素。CDI的发病率在全球范围内不断增加,尤其是高产毒株在北美地区造成了医院内的暴发流行,引起了世界范围的关注。在此对艰难梭菌的致病机制和实验室诊断方法的研究进展进行阐述,为艰难梭菌相关性腹泻的早期诊断和治疗提供新思路。 相似文献
15.
艰难梭菌是抗生素相关性腹泻及伪膜性肠炎等医院获得性感染性疾病的主要病原菌。近些年高致病性BI/NAP1/027核糖体分型成为流行菌株,时常出现感染爆发流行,复发率及病死率呈上升趋势,造成极大的人力、财力、物力损失。因此,重视起艰难梭菌感控是必要的。疫苗研究是防治艰难梭菌的重要手段,国外研制艰难梭菌疫苗近20年,取得了一定进展。本文将对艰难梭菌预防及疫苗研究现状进行总结,期望能为临床医师和科研人员提供参考。 相似文献
16.
17.
Bartlett JG 《The Journal of critical illness》1994,9(12):1063-1067
Most cases of antibiotic-associated diarrhea are due to Clostridium difficile or are of enigmatic etiology. The antibiotics most often implicated are clindamycin, ampicillin or amoxicillin, and the cephalosporins. Clinical signs of antibiotic-associated diarrhea may be limited to watery stools; however, evidence of colitis (fever, cramps, leukocytosis, fecal leukocytes) suggests C. difficile infection. The tissue culture assay for C. difficile toxin remains the gold standard for diagnosis, but the enzyme immunoassay is a practical and reasonably accurate alternative. Anatomic changes, such as pseudomembranes, can be confirmed with endoscopy, but such evaluation is not required for diagnosis of C. difficile-associated pseudomembranous colitis. 相似文献
18.
19.
Treatment of Clostridium difficile-associated diarrhea 总被引:1,自引:0,他引:1
OBJECTIVE: To review the literature related to the treatment and infection control of Clostridium difficile-associated diarrhea (CDAD). DATA SOURCES: A MEDLINE search (1966-August 2001) of the English literature was conducted. DATA SYNTHESIS: C. difficile is a leading cause of antibiotic-related diarrhea. The clinical spectrum extends from simple diarrhea to fulminant colitis. Cessation of antibiotic therapy alone is sufficient for mild cases; however, the majority of cases require oral metronidazole as the drug of choice. Vancomycin orally is reserved for patients who have failed to respond to metronidazole, are pregnant, or are severely ill. There is an important role for infection control interventions. CONCLUSIONS: CDAD is a common infection. Appropriate antibiotic treatment and infection control policies can prevent the spread and reduce the morbidity associated with this disease. 相似文献