McFarland Lynne V
Department of Health Services Research and Development, Puget Sound VA Health Care System, Seattle, WA, USA.
Nat Clin Pract Gastroenterol Hepatol. 2008 Jan;5(1):40-8. doi: 10.1038/ncpgasthep1029.
In the past, Clostridium difficile-associated disease (CDAD) was thought of mainly as a nosocomial disease associated with the use of broad-spectrum antibiotics, but its epidemiology seems to be changing. Since 2002, outbreaks of severe CDAD associated with increased mortality and reduced effectiveness of treatment with metronidazole have focused attention on this challenging pathogen. A fluoroquinolone-resistant strain of C. difficile (BI/NAP1/027) has been predominantly associated with these outbreaks. Changes in the epidemiology of CDAD include the emergence of new at-risk populations and the increased incidence of the disease. Infection control programs and more effective treatments offer hope that future outbreaks of CDAD can be controlled.
过去，艰难梭菌相关性疾病（CDAD）主要被认为是一种与使用广谱抗生素相关的医院感染性疾病，但它的流行病学似乎正在发生变化。自2002年以来，与死亡率增加以及甲硝唑治疗效果降低相关的严重CDAD暴发已将人们的注意力聚焦于这种具有挑战性的病原体。一种对氟喹诺酮耐药的艰难梭菌菌株（BI/NAP1/027）一直是这些暴发的主要原因。CDAD流行病学的变化包括新的高危人群的出现以及该疾病发病率的增加。感染控制计划和更有效的治疗方法为未来控制CDAD的暴发带来了希望。
