Neemann Kari, Freifeld Alison
University of Nebraska Medical Center, Omaha, NE.
J Oncol Pract. 2017 Jan;13(1):25-30. doi: 10.1200/JOP.2016.018614.
Clostridium difficile is the most common cause of nosocomial diarrhea, resulting in significant morbidity and mortality in hospitalized patients. Oncology patients are particularly at risk of this infection secondary to frequent exposure to known risk factors. In a population in which diarrhea is a common adverse effect of chemotherapeutic regimens, diagnosis can be challenging secondary to current limitations in testing to differentiate between colonization and active infection. Although several currently available antimicrobial therapies achieve resolution of symptoms in this population, further research is needed to determine which agent least affects the host intestinal microbiota, especially in times of neutropenia and mucosal barrier injury. The purpose of this article is to review the current literature on the epidemiology, pathogenesis, and management of C difficile-associated diarrhea in the oncology population.
艰难梭菌是医院获得性腹泻最常见的病因，可导致住院患者出现严重的发病和死亡情况。肿瘤患者由于频繁接触已知风险因素，尤其容易感染这种病菌。在腹泻是化疗方案常见副作用的人群中，由于目前检测手段在区分定植和活动性感染方面存在局限性，诊断可能具有挑战性。尽管目前有几种抗菌疗法可使该人群的症状得到缓解，但仍需要进一步研究以确定哪种药物对宿主肠道微生物群影响最小，特别是在中性粒细胞减少和黏膜屏障受损时。本文旨在综述目前关于肿瘤人群中艰难梭菌相关性腹泻的流行病学、发病机制和管理的文献。
