艰难梭状芽胞杆菌相关感染的治疗进展

艰难梭状芽胞杆菌是医院获得性腹泻的主要病因,其产生两种蛋白质的外毒素导致结肠黏膜损伤和炎症。感染可能是无症状,或轻度腹泻,也可导致严重的伪膜性结肠炎。诊断主要依靠粪便中艰难梭菌毒素的检出。如果严重或持续性腹泻和结肠炎,口服甲硝唑和万古霉素是治疗的首选,但它们的广泛使用可能会导致抗药性院内细菌的增殖。使用其他抗菌药物,毒素吸附剂,免疫治疗,生态治疗以及执行隔离制度也是可行的策略。

Advances in the Treatment of Clostridium Difficile Infection

Clostridium difficile is the leading cause of hospital-acquired diarrhea,which produces two protein exotoxins,causing colonic mucosal injury and inflammation.Infection may be asymptomatic,or cause mild diarrhea,or result in severe pseudomembranous colitis.Diagnosis depends on the demonstration of Clostridium difficile toxins in the stool.If diarrhea and colitis are severe or persistent,oral metronidazole or vancomycin is the treatment of choice,however the widespread use may encourage the proliferation of drug-resistant nosocomial bacteria.The use of other antibacterial drugs,toxins adsorbent,immunotherapy,eco-therapy and the implementation of isolation system are also viable strategies.