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艰难梭菌感染的前沿技术。

Cutting edges in Clostridioides difficile infections.

机构信息

Division of Infectious Diseases and Hospital Epidemiology, University Hospital Basel, University of Basel, Switzerland.

Department of Clinical Research, University Hospital Basel, University of Basel, Switzerland.

出版信息

Swiss Med Wkly. 2021 Oct 6;151:w30033. doi: 10.4414/smw.2021.w30033. eCollection 2021 Sep 27.

Abstract

Clostridioides difficile is the most common cause of hospital-acquired diarrhoea and one of the most important causes of hospital-acquired infections. It results in significant morbidity, mortality and economic burden - especially in the context of recurrent infections. After initial antibiotic therapy of a C. difficile infection, recurrence occurs in about 20% of all patients, which increases the risk of further recurrence to about 45%. Traditional therapeutic options for treatment of C. difficile infection include metronidazole or vancomycin. Newer therapy options such as fidaxomicin, the administration of monoclonal antibodies or faecal microbiota transplantation demonstrate significant advantages over traditional therapies, particularly regarding the reduction of the recurrence rate. This article highlights the main differences between the recommendations of the Swiss Society for Infectious Diseases on the management of "Clostridioides difficile infection" and the IDSA/SHEA reference guideline "Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA)" and discusses some important challenges in -treatment of C. difficile.

摘要

艰难梭菌是医院获得性腹泻最常见的原因,也是医院获得性感染最重要的原因之一。它导致了显著的发病率、死亡率和经济负担,尤其是在反复感染的情况下。在艰难梭菌感染的初始抗生素治疗后,约 20%的患者会出现复发,这使进一步复发的风险增加到约 45%。治疗艰难梭菌感染的传统治疗方案包括甲硝唑或万古霉素。新的治疗方案,如非达霉素、单克隆抗体的应用或粪便微生物群移植,与传统疗法相比具有显著优势,特别是在降低复发率方面。本文重点介绍了瑞士传染病学会关于“艰难梭菌感染”管理的建议与 IDSA/SHEA 参考指南“艰难梭菌感染成人和儿童的临床实践指南:2017 年美国传染病学会(IDSA)和美国医疗保健流行病学学会(SHEA)更新”之间的主要差异,并讨论了治疗艰难梭菌感染中的一些重要挑战。

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