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感染性腹泻:概述

Infectious diarrhea: an overview.

作者信息

Dickinson Brandon, Surawicz Christina M

机构信息

Department of Medicine, University of Washington School of Medicine, Seattle, USA.

出版信息

Curr Gastroenterol Rep. 2014 Aug;16(8):399. doi: 10.1007/s11894-014-0399-8.

Abstract

Diarrheal disease, which is most often caused by infectious pathogens, is a significant cause of morbidity and mortality worldwide, especially in children. This is particularly true in developing countries. Recent outbreaks of infectious diarrhea in developed countries, including the USA, are often attributed to food handling and distribution practices and highlight the need for continued vigilance in this area. Another common cause of infectious diarrhea, Clostridium difficile infection (CDI), has historically been associated with the use of antibiotics and exposure to a health-care setting but is now increasingly common in the community in persons who lack the typical risk factors. Recent scientific advances have also led to new and proposed new therapies for infectious diarrhea, including fecal microbiota transplant (FMT) for recurrent C. difficile infection (RCDI), probiotics for prevention of antibiotic-associated diarrhea (AAD) and CDI, and the use of zinc supplementation in the treatment of acute diarrhea in children. Other therapies that have been in use for decades, such as the oral rehydration solution (ORS), continue to be the targets of scientific advancement in an effort to improve delivery and efficacy. Finally, post-infectious irritable bowel syndrome (PI-IBS) is an increasingly recognized occurrence. Attempts to understand the mechanism behind this phenomenon are underway and may provide insight into potential treatment options.

摘要

腹泻病通常由传染性病原体引起,是全球发病和死亡的重要原因,尤其是在儿童中。在发展中国家尤其如此。包括美国在内的发达国家近期爆发的传染性腹泻疫情,往往归因于食品处理和分发方式,凸显了在这一领域持续保持警惕的必要性。传染性腹泻的另一个常见病因是艰难梭菌感染(CDI),以往它与抗生素使用及医疗环境暴露有关,但现在在缺乏典型风险因素的社区人群中越来越常见。近期的科学进展还带来了针对传染性腹泻的新疗法和新提出的疗法,包括用于复发性艰难梭菌感染(RCDI)的粪便微生物群移植(FMT)、用于预防抗生素相关性腹泻(AAD)和CDI的益生菌,以及在儿童急性腹泻治疗中使用锌补充剂。其他已使用数十年的疗法,如口服补液盐(ORS),仍是科学进步的目标,旨在提高给药方式和疗效。最后,感染后肠易激综合征(PI-IBS)越来越受到关注。目前正在尝试了解这一现象背后的机制,这可能为潜在的治疗选择提供思路。

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