Gerding Dale N, File Thomas M, McDonald L Clifford
Edward Hines Jr VA Hospital, Hines, IL.
Loyola University Chicago Stritch School of Medicine, Chicago, IL.
Infect Dis Clin Pract (Baltim Md). 2016 Jan;24(1):3-10. doi: 10.1097/IPC.0000000000000350.
Early and accurate diagnosis is essential for optimal treatment of individuals with infection (CDI) and for implementation of effective infection control procedures. The decision about which diagnostic test to use is an important one that should be based on test sensitivity, specificity, and predictive value. The challenges of CDI go beyond rapid identification and management of symptomatic patients. Asymptomatic carriage has long been suspected in transmission, but it may play a larger role than previously thought. Emerging information also shows that patients treated for CDI remain colonized for many weeks after symptom resolution. In fact, stool culture positivity increases during the first weeks following treatment completion. Treatments that reduce the duration and degree of asymptomatic shedding could have added benefit for reduced transmission.
早期准确诊断对于艰难梭菌感染（CDI）患者的最佳治疗以及实施有效的感染控制措施至关重要。决定使用哪种诊断测试是一项重要决策，应基于测试的敏感性、特异性和预测价值。CDI的挑战不仅在于对有症状患者的快速识别和管理。长期以来，无症状携带一直被怀疑在传播中起作用，但它可能比以前认为的作用更大。新出现的信息还表明，CDI患者在症状缓解后数周仍处于定植状态。事实上，在治疗完成后的头几周内，粪便培养阳性率会增加。减少无症状排菌持续时间和程度的治疗方法可能对减少传播有额外益处。
