National Cheng Kung University Hospital and Medical College, Tainan, Taiwan.
Emerg Infect Dis. 2010 Aug;16(8):1204-10. doi: 10.3201/eid1608.100064.
To determine clinical characteristics and outcome of patients with Clostridium difficile bacteremia (CDB), we identified 12 patients with CDB in 2 medical centers in Taiwan; all had underlying systemic diseases. Five had gastrointestinal diseases or conditions, including pseudomembranous colitis (2 patients); 4 recalled diarrhea, but only 5 had recent exposure to antimicrobial drugs. Ten available isolates were susceptible to metronidazole and vancomycin. Five isolates had C. difficile toxin A or B. Of 5 patients who died, 3 died of CDB. Of 8 patients treated with metronidazole or vancomycin, only 1 died, and all 4 patients treated with other drugs died (12.5% vs. 100%; p = 0.01). C. difficile bacteremia, although uncommon, is thus associated with substaintial illness and death rates.
为了确定艰难梭状芽孢杆菌菌血症（CDB）患者的临床特征和结局，我们在台湾的 2 家医疗中心鉴定出 12 例 CDB 患者；所有患者都有潜在的系统性疾病。其中 5 例有胃肠道疾病或病症，包括伪膜性结肠炎（2 例）；4 例有腹泻病史，但仅有 5 例近期有抗菌药物暴露史。可获得的 10 个分离株均对甲硝唑和万古霉素敏感。5 个分离株有艰难梭菌毒素 A 或 B。5 例死亡患者中，3 例死于 CDB。在接受甲硝唑或万古霉素治疗的 8 例患者中，仅 1 例死亡，而所有接受其他药物治疗的 4 例患者均死亡（12.5% vs. 100%；p = 0.01）。因此，艰难梭状芽孢杆菌菌血症虽然不常见，但与严重疾病和高死亡率相关。
