Polívková Sylvia, Sýkorová Blanka, Džupová Olga, Reisingerová Marie, Beneš Jiří
2nd Department of Infectious Diseases, Charles University Prague, Prague, Czech Republic.
Klin Mikrobiol Infekc Lek. 2010 Dec;16(6):206-10.
Description of basic epidemiological and clinical data of patients suffering from Clostridium difficile infection (CDI). Recognizing important predisposing factors and detecting complications of the disease.
A retrospective study of clinical and laboratory parameters in patients with confirmed CDI who were admitted in our department between 1 January, 2008 and 30 June 2010. Etiology of the disease was identified using the enzyme-linked flourescent assay (ELFA).
Clostridial etiology of post-antibiotic diarrhea was found in 82 patients. Those were 44 women and 38 men, aged 5-88 years (median of 66 years). Fifty-two patients (76 %) were older than 60 years. Seventy-seven patients (92 %) were given antibiotics before the onset of the disease, three patients received cytostatic therapy. In most cases, the disease began after treatment with aminopenicillins, third-generation cephalosporins or fluoroquinolones. Fifty-three patients (65 %) reported previous hospitalization. In 17 patients (21 %), the disease recurred; two patients developed ileus. Eleven patients died; with the death being caused by CDI in four of them.
CDI is a live-threatening disease mainly affecting elderly hospitalized patients with comorbidities. The most important predisposing factor is the administration of broadspectrum antibiotics. Early diagnosis and treatment may improve the prognosis of serious cases.
描述艰难梭菌感染（CDI）患者的基本流行病学和临床数据。识别重要的易感因素并检测该疾病的并发症。
对2008年1月1日至2010年6月30日期间入住我科的确诊CDI患者的临床和实验室参数进行回顾性研究。采用酶联荧光分析法（ELFA）确定疾病病因。
82例患者被发现抗生素相关性腹泻的病因是梭菌。其中44例为女性，38例为男性，年龄5至88岁（中位数66岁）。52例患者（76%）年龄大于60岁。77例患者（92%）在疾病发作前使用过抗生素，3例患者接受过细胞毒性治疗。在大多数情况下，疾病在使用氨基青霉素、第三代头孢菌素或氟喹诺酮类药物治疗后开始。53例患者（65%）报告曾住院治疗。17例患者（21%）疾病复发；2例患者发生肠梗阻。11例患者死亡；其中4例患者的死亡由CDI导致。
CDI是一种危及生命的疾病，主要影响患有合并症的老年住院患者。最重要的易感因素是使用广谱抗生素。早期诊断和治疗可能改善重症病例的预后。
