Am J Gastroenterol. 2012 Jan;107(1):96-8. doi: 10.1038/ajg.2011.404.
Clostridium difficile infection is widely accepted to be the leading cause of nosocomial infection-related morbidity and mortality, outpacing both antibiotic-resistant staphylococcus and enterococcus. The existence and prevalence of community-acquired Clostridium difficile infection, on the other hand, is much less well appreciated. Growing evidence now suggests that community-acquired Clostridium difficile infection may account for more than a third of Clostridium difficile-associated diarrhea overall. Similar to nosocomial Clostridium difficile infection, community-acquired cases appear to be increasing in incidence, and although associated mortality is lower than in nosocomial cases, morbidity including hospitalization and recurrence are high. Further, traditional risk factors for Clostridium difficile infection including antibiotic exposure appear to be less important in community-acquired cases and common routes of exposure and infection in the community are yet to be elucidated. In this issue of the American Journal of Gastroenterology, Khanna et al. provide important epidemiological data on the growing threat of community-acquired Clostridium difficile infection.
艰难梭菌感染被广泛认为是导致医院感染相关发病率和死亡率的主要原因，超过了耐抗生素的葡萄球菌和肠球菌。然而，社区获得性艰难梭菌感染的存在和流行程度却远未得到充分认识。越来越多的证据表明，社区获得性艰难梭菌感染可能占总体艰难梭菌相关性腹泻的三分之一以上。与医院获得性艰难梭菌感染相似，社区获得性病例的发病率似乎在增加，尽管其相关死亡率低于医院获得性病例，但发病率包括住院和复发率很高。此外，艰难梭菌感染的传统危险因素，包括抗生素暴露，在社区获得性病例中似乎不太重要，而且社区中常见的暴露和感染途径仍有待阐明。在本期《美国胃肠病学杂志》上，Khanna 等人提供了关于日益严重的社区获得性艰难梭菌感染威胁的重要流行病学数据。
