Shen Aimee
Department of Molecular Biology and Microbiology, Tufts University School of Medicine, Boston, Massachusetts.
Clin Colon Rectal Surg. 2020 Mar;33(2):58-66. doi: 10.1055/s-0040-1701230. Epub 2020 Feb 25.
The Gram-positive, spore-forming bacterium, is the leading cause of healthcare-associated infections in the United States, although it also causes a significant number of community-acquired infections. infections, which range in severity from mild diarrhea to toxic megacolon, cost more to treat than matched infections, with an annual treatment cost of approximately $6 billion for almost half-a-million infections. These high-treatment costs are due to the high rates of disease recurrence (>20%) and necessity for special disinfection measures. These complications arise in part because makes metabolically dormant spores, which are the major infectious particle of this obligate anaerobe. These seemingly inanimate life forms are inert to antibiotics, resistant to commonly used disinfectants, readily disseminated, and capable of surviving in the environment for a long period of time. However, upon sensing specific bile salts in the vertebrate gut, spores transform back into the vegetative cells that are responsible for causing disease. This review discusses how spores are ideal vectors for disease transmission and how antibiotics modulate this process. We also describe the resistance properties of spores and how they create challenges eradicating spores, as well as promote their spread. Lastly, environmental reservoirs of spores and strategies for destroying them particularly in health care environments will be discussed.
这种革兰氏阳性、形成芽孢的细菌是美国医疗保健相关感染的主要原因，不过它也会引发大量社区获得性感染。其感染症状严重程度不一，从轻度腹泻到中毒性巨结肠，治疗成本高于其他相应感染，近50万例感染的年治疗成本约为60亿美元。这些高昂的治疗成本归因于疾病复发率高（>20%）以及采取特殊消毒措施的必要性。这些并发症部分是因为该细菌会形成代谢休眠芽孢，而芽孢是这种专性厌氧菌的主要感染颗粒。这些看似无生命的生命形式对抗生素呈惰性，对常用消毒剂具有抗性，易于传播，并且能够在环境中长时间存活。然而，一旦感知到脊椎动物肠道中的特定胆盐，该细菌的芽孢就会转化回引发疾病的营养细胞。本综述讨论了芽孢如何成为疾病传播的理想载体以及抗生素如何调节这一过程。我们还描述了芽孢的抗性特性以及它们如何在根除芽孢方面带来挑战并促进其传播。最后，将讨论该细菌芽孢的环境储存库以及在医疗保健环境中尤其是销毁它们的策略。
