Szczesny Adam, Martirosian Gajane
II Zakładu Anestezjologii i Intensywnej Terapii SP CSK Akademii Medycznej w Warszawie.
Wiad Lek. 2003;56(5-6):278-82.
Cases of antibiotic-associated diarrhoea (AAD) associated with toxigenic C. difficile strains more frequently are described recently. In Polish studies diagnosis of AAD or PMC (pseudomembranous colitis) was confirmed by isolation of C. difficile strains in 52% of suspected cases. Strains of C. difficile were isolated also from samples taken from hospital environment (10.5% positive samples). Problem of C. difficile-associated infection is more frequently observed in Poland also because of uncontrolled using of wide spectrum antibiotics. These antibiotics destroy intestinal microflora--"colonization resistance factor". Cases of AAD or PMC were described even after treatment of patients by vancomycin or metronidazol--antibiotics of choice for treatment of C. difficile-associated diseases. Other risk factors as: age, long term hospitalization, previous surgery, colonoscopy are also taken into account, when C. difficile-associated infections are suspected. Different treatment methods of C. difficile-associated infections are reviewed here and discussed in light of recent publications.
近年来，与产毒艰难梭菌菌株相关的抗生素相关性腹泻（AAD）病例报道更为频繁。在波兰的研究中，52%的疑似AAD或伪膜性结肠炎（PMC）病例通过分离出艰难梭菌菌株得以确诊。从医院环境采集的样本中也分离出了艰难梭菌菌株（阳性样本占10.5%）。在波兰，由于广谱抗生素的无节制使用，艰难梭菌相关感染问题也更为常见。这些抗生素会破坏肠道微生物群——“定植抗性因子”。即使在使用万古霉素或甲硝唑（治疗艰难梭菌相关疾病的首选抗生素）治疗患者后，仍有AAD或PMC病例的报道。当怀疑存在艰难梭菌相关感染时，其他风险因素如年龄、长期住院、既往手术、结肠镜检查等也会被考虑在内。本文回顾了艰难梭菌相关感染的不同治疗方法，并结合近期出版物进行了讨论。
