Section of Infectious Diseases, Department of Medicine, University of Wisconsin Medical School, Madison, WI 53792, USA.
Int J Infect Dis. 2009 Nov;13(6):663-7. doi: 10.1016/j.ijid.2008.11.012. Epub 2009 Jan 30.
Clostridium difficile is the most common infectious cause of nosocomial healthcare-associated diarrhea. The increasing prevalence of C difficile, spread in the community, virulence and frequent relapse has created an urgent need to identify new effective treatments for C. difficile infection. Among these, intravenous immunoglobulin (IVIG) is used for cases of severe C. difficile infection. We undertook a systematic review to examine the published literature pertaining to the use of immunoglobulin for C. difficile infection. Four retrospective studies and five case reports that addressed the use of IVIG for the treatment of C. difficile infection were identified. One study on the use of oral immunoglobulin was identified. Although overall there appear to be benefits to using IVIG in recurrent severe disease, the small sample sizes and lack of control groups in three of the four studies do not allow recommendations to be made regarding the use of immunoglobulin in C. difficile infection. Further research is urgently needed to clarify the role of immunoglobulin--intravenous or oral--for the treatment of C. difficile infection.
艰难梭菌是医院获得性医疗相关腹泻最常见的感染性病因。艰难梭菌在社区中的传播、毒力和频繁复发的流行率不断上升，这就迫切需要寻找新的有效治疗艰难梭菌感染的方法。在这些方法中，静脉注射免疫球蛋白（IVIG）用于治疗严重的艰难梭菌感染。我们进行了一项系统评价，以检查与免疫球蛋白治疗艰难梭菌感染相关的已发表文献。确定了四项回顾性研究和五项关于 IVIG 治疗艰难梭菌感染的病例报告。一项关于口服免疫球蛋白使用的研究也被确定。尽管在复发性严重疾病中使用 IVIG 似乎有一定益处，但四项研究中有三项的样本量较小且缺乏对照组，因此无法就免疫球蛋白在艰难梭菌感染中的应用提出建议。迫切需要进一步的研究来阐明静脉注射或口服免疫球蛋白在治疗艰难梭菌感染中的作用。
