University of Arkansas Medical Sciences, Department of Pediatrics, Pediatric Pulmonology, Arkansas Children's Hospital, United States.
University of Arkansas Medical Sciences, Department of Pathology, United States.
J Cyst Fibros. 2014 Jan;13(1):37-42. doi: 10.1016/j.jcf.2013.08.005. Epub 2013 Aug 29.
Patients with cystic fibrosis (CF) have several risk factors for Clostridium difficile colonization such as frequent hospitalization and exposure to a broad array of antibiotics utilized for the control, eradication, and prophylaxis of respiratory pathogens. However, despite this high rate of colonization, the occurrence of C. difficile infection (CDI) in CF is rare. We report three children with CF who presented with severe community-associated CDI. All three children had complicated courses and one died. These children were in good health without significant morbidities, and were not frequently hospitalized nor did they receive frequent antibiotic courses. The occurrence of 3 severe cases within a 15-month period prompted us to report these cases and review the literature in regard to CDI. We reviewed the CF GI tract as possible risk factors for a high rate of C. difficile colonization in individuals with CF. Since a high percentage of individuals with CF are on gastric acid blocking agents, we also focused on gastric acid suppression as a potential risk factor for CDI.
囊性纤维化 (CF) 患者存在多种艰难梭菌定植的危险因素，例如频繁住院以及接触广泛的抗生素，这些抗生素用于控制、根除和预防呼吸道病原体。然而，尽管定植率很高，但 CF 中艰难梭菌感染 (CDI) 的发生率却很低。我们报告了 3 例 CF 合并社区获得性严重 CDI 的患儿。这 3 例患儿均病情复杂，其中 1 例死亡。这些患儿身体健康，无明显合并症，住院次数不多，也未接受频繁的抗生素治疗。在 15 个月内发生 3 例严重病例促使我们报告这些病例，并对 CDI 相关文献进行复习。我们回顾了 CF 胃肠道，因为 CF 患者中艰难梭菌定植率高可能与胃肠道有关。由于 CF 患者中有很大一部分人使用胃酸阻断剂，因此我们也关注了胃酸抑制作为 CDI 的潜在危险因素。
