National Reference Laboratory for C. difficile, Hôpital Saint-Antoine, Paris, France.
Université Paris Descartes, Faculté de Pharmacie, Paris, France.
Adv Exp Med Biol. 2018;1050:45-58. doi: 10.1007/978-3-319-72799-8_4.
Clostridium difficile is a major bacterial cause of post-antibiotic diarrhoea. The epidemiology of C. difficile infections (CDI) has dramatically changed since the early 2000s, with an increasing incidence and severity across Europe. This trend is partly due to the emergence and rapid worldwide spread of the hypervirulent and epidemic PCR ribotype 027. Profiles of patients with CDI have also evolved, with description of community-acquired (CA) infections in patients with no traditional risk factors for CDI. However, recent epidemiological studies indicated that some European countries have successfully controlled the dissemination of the 027 clone whereas other countries recently reported the emergence of other virulent or unusual strains. The aims of this review are to summarize the current European CDI epidemiology and to describe the new virulent C. difficile strains circulating in Europe, as well as other potential emerging strains described elsewhere. Standardized typing methods and surveillance programmes are mandatory for a better understanding and monitoring of CDI in Europe.
艰难梭菌是一种主要的细菌性抗生素后腹泻病原体。自 21 世纪初以来，艰难梭菌感染（CDI）的流行病学发生了显著变化，欧洲各地的发病率和严重程度都在增加。这种趋势部分归因于高毒力和流行的 PCR 核糖体 027 型的出现和迅速在全球范围内传播。CDI 患者的特征也发生了变化，在没有 CDI 传统危险因素的患者中出现了社区获得性（CA）感染。然而，最近的流行病学研究表明，一些欧洲国家已成功控制了 027 克隆的传播，而其他国家最近则报告了其他毒力更强或不常见的菌株的出现。本综述的目的是总结当前欧洲 CDI 的流行病学，并描述在欧洲流行的新型毒力艰难梭菌菌株，以及其他在其他地方描述的潜在新兴菌株。标准化的分型方法和监测计划对于更好地理解和监测欧洲的 CDI 是必要的。
