Modi N, Wilcox M H
Department of Microbiology, The General Infirmary and University of Leeds, Old Medical School, Leeds, LS1 3EX, UK.
J Clin Pathol. 2001 Oct;54(10):748-51. doi: 10.1136/jcp.54.10.748.
Clostridium difficile is a well documented cause of antibiotic associated diarrhoea in hospitalised patients, but may account for only approximately 20% of all cases. This leader reviews the current knowledge and understanding of the pathogenesis, epidemiology, and diagnosis of non-food borne Clostridium perfringens diarrhoea. Although enterotoxigenic C perfringens has been implicated in some C difficile negative cases of antibiotic associated diarrhoea, C perfringens enterotoxin detection methods are not part of the routine laboratory investigation of such cases. Testing for C perfringens enterotoxin in faecal samples from patients with antibiotic associated diarrhoea and sporadic diarrhoea on a routine basis would have considerable resource implications. Therefore, criteria for initiating investigations and optimum laboratory tests need to be established. In addition, establishing the true burden of C perfringens antibiotic associated diarrhoea is important before optimum control and treatment measures can be defined.
艰难梭菌是住院患者抗生素相关性腹泻的一个有充分文献记载的病因，但在所有病例中可能仅占约20%。本述评回顾了目前对非食源性产气荚膜梭菌腹泻的发病机制、流行病学及诊断的认识。尽管产肠毒素产气荚膜梭菌已被认为与某些艰难梭菌阴性的抗生素相关性腹泻病例有关，但产气荚膜梭菌肠毒素检测方法并非此类病例常规实验室检查的一部分。对患有抗生素相关性腹泻和散发性腹泻患者的粪便样本进行产气荚膜梭菌肠毒素的常规检测会带来相当大的资源问题。因此，需要确立启动调查的标准和最佳实验室检测方法。此外，在确定最佳控制和治疗措施之前，明确产气荚膜梭菌抗生素相关性腹泻的实际负担很重要。
