Department of Internal Medicine, Division of Infectious and Immunologic Diseases, University of California Davis Medical Center, Sacramento, California, USA.
Infect Control Hosp Epidemiol. 2010 May;31(5):431-55. doi: 10.1086/651706.
Since publication of the Society for Healthcare Epidemiology of America position paper on Clostridium difficile infection in 1995, significant changes have occurred in the epidemiology and treatment of this infection. C. difficile remains the most important cause of healthcare-associated diarrhea and is increasingly important as a community pathogen. A more virulent strain of C. difficile has been identified and has been responsible for more-severe cases of disease worldwide. Data reporting the decreased effectiveness of metronidazole in the treatment of severe disease have been published. Despite the increasing quantity of data available, areas of controversy still exist. This guideline updates recommendations regarding epidemiology, diagnosis, treatment, and infection control and environmental management.
自 1995 年美国医疗保健流行病学学会发表关于艰难梭菌感染的立场文件以来,该感染的流行病学和治疗发生了重大变化。艰难梭菌仍然是医疗保健相关腹泻的最重要原因,并且作为社区病原体的重要性日益增加。已经确定了一种毒力更强的艰难梭菌菌株,并且在全球范围内导致了更严重的疾病。已经发表了关于甲硝唑治疗严重疾病效果降低的数据报告。尽管可用数据量不断增加,但仍存在争议领域。本指南更新了关于流行病学、诊断、治疗以及感染控制和环境管理的建议。