Institute of Antibiotics, Huashan Hospital, Fudan University, Shanghai, China.
Int J Antimicrob Agents. 2009 Dec;34(6):516-22. doi: 10.1016/j.ijantimicag.2009.09.012. Epub 2009 Oct 13.
Clostridium difficile is the leading cause of hospital-acquired diarrhoea and the number of outbreaks has risen markedly since 2003. The emergence and spread of resistance in C. difficile is complicating treatment and prevention. Most isolates are still susceptible to vancomycin and metronidazole (MTZ), however transient and heteroresistance to MTZ have been reported. The prevalence of resistance to other antimicrobial agents is highly variable in different populations and in different countries, ranging from 0% to 100%. Isolates of common polymerase chain reaction (PCR) ribotypes are more resistant than uncommon ribotypes. Most of the resistance mechanisms that have been identified in C. difficile are similar to those in other Gram-positive bacteria, including mutation, selection and acquisition of the genetic information that encodes resistance. Better antibiotic stewardship and infection control are needed to prevent further spread of resistance in C. difficile.
艰难梭菌是导致医院获得性腹泻的主要原因，自 2003 年以来，其爆发的数量显著增加。艰难梭菌的耐药性的出现和传播使治疗和预防变得更加复杂。大多数分离株仍然对万古霉素和甲硝唑（MTZ）敏感，然而，已经报道了 MTZ 的短暂和异质耐药性。不同人群和不同国家对其他抗菌药物的耐药率差异很大，从 0%到 100%不等。常见聚合酶链反应（PCR）核糖体型的分离株比不常见的核糖体型更耐药。艰难梭菌中已鉴定出的大多数耐药机制与其他革兰氏阳性菌相似，包括突变、选择和获得编码耐药性的遗传信息。需要更好的抗生素管理和感染控制，以防止艰难梭菌的耐药性进一步传播。
