Khan Areej, Raza Shahzad, Batul Syeda A, Khan Monis, Aksoy Tulay, Baig Mahadi A, Berger Barbara J
Department of Internal Medicine, Brookdale University Hospital & Medical Center, Brooklyn, New York 11212, USA.
Recent Pat Antiinfect Drug Discov. 2012 Aug;7(2):157-70. doi: 10.2174/157489112801619674.
Clostridium difficile infection (CDI) has emerged as a significant challenge to the healthcare system. The availability of anti-cancer chemotherapeutic regimens has contemporaneously resulted in a larger population of patients who are susceptible to CDI. The outbreak of a novel, hypervirulent, resistant strain, NAP-1/027 as well as resistance to antibiotic therapy have further contributed to an increase in prevalence as well as in disease severity. Recent data show high fatality rates in cancer patients with CDI. In this review, we have discussed the incidence, epidemiology, pathophysiology, clinical signs and symptoms and therapeutic guidelines for patients who are on chemotherapy and present with CDI and highlighted clinical reports documenting severe CDI associated with chemotherapeutic agents such as methotrexate, 5FU, cisplatin, carboplatin, paclitaxel, vinorelbine and cyclophosphamide. The review article also has the discussion of patents pertaining to infections caused by Clostridium difficile in cancer patients. We underscore the urgent need for early recognition and diagnosis of CDI in cancer patients and for the design and implementation of randomized clinical trials of new treatment modalities in the management of chemotherapy- associated CDI.
艰难梭菌感染（CDI）已成为医疗保健系统面临的一项重大挑战。抗癌化疗方案的应用同时导致了更多易患CDI的患者群体。一种新型、高毒力、耐药菌株NAP-1/027的爆发以及对抗生素治疗的耐药性进一步导致了发病率和疾病严重程度的增加。近期数据显示，患有CDI的癌症患者死亡率很高。在本综述中，我们讨论了接受化疗且出现CDI的患者的发病率、流行病学、病理生理学、临床体征和症状以及治疗指南，并重点介绍了记录与甲氨蝶呤、5-氟尿嘧啶、顺铂、卡铂、紫杉醇、长春瑞滨和环磷酰胺等化疗药物相关的严重CDI的临床报告。这篇综述文章还讨论了与癌症患者艰难梭菌感染相关的专利。我们强调迫切需要对癌症患者的CDI进行早期识别和诊断，并设计和实施新治疗模式的随机临床试验，以管理化疗相关的CDI。
