Blanckaert K, Coignard B, Grandbastien B, Astagneau P, Barbut F
Centre de coordination de la lutte contre les infections nosocomicales Paris-Nord, 15, rue de L'école-de-médecine, 75006 Paris, France.
Rev Med Interne. 2008 Mar;29(3):209-14. doi: 10.1016/j.revmed.2007.09.029. Epub 2007 Oct 22.
Clostridium difficile is an anaerobic gram positive, spore-forming bacterium which is responsible for 15-25% of antibiotic-associated diarrhea and for more than 95% of pseudomembranous colitis (PMC). This paper will review the main knowledge on C. difficile-associated infections and their recent evolution.
Since 2003, outbreaks of severe C. difficile-associated diarrhea (CDAD) have been increasingly reported in Canada and the United States. This trend is assumed to be associated with the rapid emergence and spread of a specific clone of C. difficile belonging to PCR-ribotype 027 or North American Pulsotype 1, pulsotype (NAP1). This clone is characterized by the overproduction of toxins A and B and is positive for a third toxin named binary toxin. This clone has spread in UK, in Belgium, in the Netherlands, and, more recently, in France where it has been responsible for large outbreaks mainly in northern France.
A systematic reporting of C. difficile incidence by health facilities should enable a better assessment of this pathology in France.
艰难梭菌是一种厌氧革兰氏阳性产芽孢细菌，它导致15%至25%的抗生素相关性腹泻以及超过95%的伪膜性结肠炎（PMC）。本文将综述关于艰难梭菌相关性感染的主要知识及其近期进展。
自2003年以来，加拿大和美国越来越多地报告了严重的艰难梭菌相关性腹泻（CDAD）疫情。这种趋势被认为与属于PCR核糖体分型027或北美脉冲型1（脉冲型（NAP1））的特定艰难梭菌克隆的迅速出现和传播有关。该克隆的特征是毒素A和B过度产生，并且对第三种名为二元毒素的毒素呈阳性。该克隆已在英国、比利时、荷兰传播，最近在法国也有传播，在法国主要在北部引发了大规模疫情。
医疗机构对艰难梭菌发病率进行系统报告应能更好地评估法国的这种病理情况。
