Division of Infectious Diseases and Department of Infection Prevention and Control, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA.
Curr Opin Pediatr. 2013 Feb;25(1):116-21. doi: 10.1097/MOP.0b013e32835bf6c0.
Clostridium difficile is the most common cause of healthcare-associated diarrhea among adults in Western countries, and is increasingly recognized as an important pathogen in children. This review provides an update on the changing epidemiology of C. difficile infection (CDI) for pediatric providers and summarizes current knowledge regarding available therapies.
The incidence of CDI has more than doubled among adults over the past decade, with a particular rise in incidence among patients presenting from the community. CDI has also increased among children in both inpatient and outpatient settings and there is growing evidence that specific populations of children may be at highest risk. Antibiotic-based therapies remain the mainstay of treatment for CDI, but new therapies have been developed with potential future applications in children. Use of nonantibiotic-based therapies is limited in children, but their use has been studied among adults with intractable or recurrent disease.
The rise in incidence of CDI over the past decade warrants increased recognition by pediatric providers. Knowledge of the pediatric populations at highest risk for infection as well as the options for therapy will improve understanding of this changing disease.
艰难梭菌是西方国家成人医源性腹泻最常见的病原体,且日益被认为是儿童中的重要病原体。本文就艰难梭菌感染(CDI)的流行情况为儿科医生提供最新信息,并总结目前对现有治疗方法的认识。
过去十年,成人 CDI 的发病率增加了一倍以上,尤其是来自社区的患者发病率上升。儿童住院和门诊患者中的 CDI 也有所增加,越来越多的证据表明,某些特定儿童群体可能面临最大的风险。抗生素治疗仍然是 CDI 的主要治疗方法,但已开发出一些新的治疗方法,将来可能在儿童中应用。非抗生素治疗在儿童中的应用有限,但已在难治性或复发性疾病的成人中进行了研究。
过去十年中 CDI 的发病率上升,值得儿科医生提高认识。了解感染风险最高的儿科人群以及治疗选择将有助于了解这种不断变化的疾病。