Department of Gastroenterology, Renmin Hospital of Wuhan University, No. 99 Zhang Zhidong Road, Wuhan 430000, Hubei, China.
Can J Gastroenterol Hepatol. 2022 Jun 7;2022:4209442. doi: 10.1155/2022/4209442. eCollection 2022.
is a Gram-positive bacillus with fecal-oral transmission and is currently one of the most common nosocomial infections worldwide, which was renamed in 2016. infection (CDI) is a prevalent infection in cirrhosis and negatively affects prognosis. This study aimed to provide a concise review with clinical practice implications. The prevalence of CDI in cirrhotic patients increases, while the associated mortality decreases. Multiple groups of risk factors increase the likelihood of CDI in patients with cirrhosis, such as antibiotic use, the severity of cirrhosis, some comorbidities, and demographic aspects. Treatment in the general population is currently described in the latest guidelines. In patients with cirrhosis, rifaximin and lactulose have been shown to reduce CDI risk due to their modulatory effects on the intestinal flora, although conflicting results exist. Fecal microbiota transplantation (FMT) as a treatment for the second or subsequent CDI recurrences has demonstrated a good safety and efficacy in cirrhosis and CDI. Future validation in more prospective studies is needed. Screening of asymptomatic patients appears to be discouraged for the prevention currently, with strict hand hygiene and cleaning of the ward and medical equipment surfaces being the cornerstone of minimizing transmission.
是一种革兰氏阳性杆菌，通过粪-口途径传播，目前是全球最常见的医院获得性感染之一，2016 年更名为 。感染（CDI）在肝硬化中普遍存在，并对预后产生负面影响。本研究旨在提供一份具有临床实践意义的简明综述。CDI 在肝硬化患者中的患病率增加，而相关死亡率降低。多组危险因素增加了肝硬化患者发生 CDI 的可能性，如抗生素使用、肝硬化严重程度、某些合并症和人口统计学方面。目前，最新指南中描述了一般人群的治疗方法。在肝硬化患者中，利福昔明和乳果糖已被证明可通过调节肠道菌群来降低 CDI 的风险，尽管存在相互矛盾的结果。粪便微生物群移植（FMT）作为治疗第二次或随后的 CDI 复发，在肝硬化和 CDI 中显示出良好的安全性和疗效。需要更多前瞻性研究进行未来验证。目前不建议对无症状患者进行筛查预防，严格的手部卫生以及病房和医疗设备表面的清洁是最大限度减少传播的基石。
