Benoit R, Dorval D, Loulergue J, Bacq Y, Oliver J M, Audurier A, Metman E H
Service de Gastroentérologie, Hôpital Trousseau, CHU, Tours.
Gastroenterol Clin Biol. 1992;16(11):860-4.
From May 1989 to January 1991, 20 patients were investigated for antibiotic-associated acute diarrhea. Colonoscopy or rectosigmoidoscopy was performed in each patient. Cultures of colonic mucosal biopsies were carried out using conventional culture grounds (cystine-lactose-electrolyte-deficient). The aim of this study was to investigate the role of a gram negative bacillus: Klebsiella oxytoca. Among the 20 patients with antibiotic-associated acute diarrhea, 11 had bloody and mucus diarrhea and colitis ranging from a right-sided hemorrhagic to diffuse acute ulcerative or erosive colitis, 7 had a grossly normal colonic appearance, while 2 had mucus diarrhea and pseudomembranous colitis. Of colonic biopsies cultures obtained from 36 control patients, 15 had a normal colonic appearance, 15 had ulcerative or crohn's colitis, 6 had well-tolerated amoxicillin therapy. Klebsiella oxytoca was never found in the 36 control patients; Klebsiella oxytoca was noted among 8/11 patients with mucus-discharging and bloody diarrhea. These results suggest that antibiotic-associated, non pseudomembranous colitis is frequently associated with Klebsiella oxytoca infection, which may be the cause of this type of colitis.
1989年5月至1991年1月，对20例抗生素相关性急性腹泻患者进行了调查。对每位患者进行了结肠镜检查或直肠乙状结肠镜检查。使用传统培养基（胱氨酸-乳糖-电解质缺乏培养基）对结肠黏膜活检组织进行培养。本研究的目的是调查革兰氏阴性杆菌：产酸克雷伯菌的作用。在20例抗生素相关性急性腹泻患者中，11例有血性和黏液性腹泻以及结肠炎，范围从右侧出血性到弥漫性急性溃疡性或糜烂性结肠炎，7例结肠外观大致正常，2例有黏液性腹泻和假膜性结肠炎。从36例对照患者获得的结肠活检组织培养物中，15例结肠外观正常，15例有溃疡性或克罗恩病性结肠炎，6例接受了耐受性良好的阿莫西林治疗。36例对照患者中从未发现产酸克雷伯菌；在11例有黏液排出和血性腹泻的患者中，8例发现了产酸克雷伯菌。这些结果表明，抗生素相关性非假膜性结肠炎常与产酸克雷伯菌感染有关，产酸克雷伯菌感染可能是这类结肠炎的病因。
