Department of Pediatrics, University of Pennsylvania School of Medicine, PA, USA.
JAMA Pediatr. 2013 Jun;167(6):567-73. doi: 10.1001/jamapediatrics.2013.441.
Clostridium difficile is the most common cause of health care-associated diarrhea among adults in the United States and is associated with significant morbidity and mortality. During the past decade, the epidemiology of C difficile infection (CDI) has changed, including a rise in the rate and severity of infection related to the emergence of a hypervirulent strain as well as an increase in disease among outpatients in community settings. Although less is known about CDI among pediatric patients, C difficile is increasingly recognized as an important pathogen among children. In this review, we discuss recent updates in the incidence and epidemiology of CDI among children, including risk factors for infection, and highlight the importance of CDI in special populations of children, particularly those with inflammatory bowel disease or cancer. In addition, we review current knowledge in the areas of diagnosis and management of CDI among children and highlight future areas for research.
艰难梭菌是美国成人医疗保健相关腹泻的最常见原因，与显著的发病率和死亡率相关。在过去十年中，艰难梭菌感染（CDI）的流行病学发生了变化，包括与一种高毒力菌株的出现相关的感染率和严重程度的上升，以及社区环境中门诊患者疾病的增加。尽管关于儿科患者 CDI 的了解较少，但艰难梭菌越来越被认为是儿童中的一种重要病原体。在这篇综述中，我们讨论了儿童中 CDI 的发病率和流行病学的最新更新，包括感染的危险因素，并强调了 CDI 在儿童特殊人群中的重要性，特别是那些患有炎症性肠病或癌症的儿童。此外，我们还回顾了儿童 CDI 的诊断和管理领域的现有知识，并强调了未来的研究领域。
