Department of Precision Medicine, University of Campania "Luigi Vanvitelli," Naples 80138, Italy.
Department of Molecular Oncology, Precision Medicine Laboratory and COVID19 Laboratory, Biogem Scarl, Ariano Irpino 83031, Italy.
World J Gastroenterol. 2023 Jun 14;29(22):3385-3399. doi: 10.3748/wjg.v29.i22.3385.
(formerly called , ) infection (CDI) is listed as an urgent threat on the 2019 antibiotic resistance threats report in the United States by the Centers for Disease Control and Prevention. Early detection and appropriate disease management appear to be essential. Meanwhile, although the majority of cases are hospital-acquired CDI, community-acquired CDI cases are also on the rise, and this vulnerability is not limited to immunocompromised patients. Gastrointestinal treatments and/or gastrointestinal tract surgeries may be required for patients diagnosed with digestive diseases. Such treatments could suppress or interfere with the patient's immune system and disrupt gut flora homeostasis, creating a suitable microecosystem for overgrowth. Currently, stool-based non-invasive screening is the first-line approach to CDI diagnosis, but the accuracy is varied due to different clinical microbiology detection methods; therefore, improving reliability is clearly required. In this review, we briefly summarised the life cycle and toxicity of , and we examined existing diagnostic approaches with an emphasis on novel biomarkers such as microRNAs. These biomarkers can be easily detected through non-invasive liquid biopsy and can yield crucial information about ongoing pathological phenomena, particularly in CDI.
艰难梭菌感染(CDI)被美国疾病控制与预防中心(Centers for Disease Control and Prevention)在 2019 年的抗生素耐药性威胁报告中列为紧急威胁。早期检测和适当的疾病管理似乎至关重要。同时,尽管大多数病例为医院获得性 CDI,但社区获得性 CDI 病例也在增加,而且这种易感性不仅限于免疫功能低下的患者。患有消化系统疾病的患者可能需要进行胃肠治疗和/或胃肠道手术。这些治疗可能会抑制或干扰患者的免疫系统并破坏肠道菌群的平衡,为艰难梭菌过度生长创造一个合适的微生态系统。目前,基于粪便的非侵入性筛查是 CDI 诊断的首选方法,但由于不同的临床微生物学检测方法,其准确性各不相同;因此,显然需要提高可靠性。在这篇综述中,我们简要总结了艰难梭菌的生命周期和毒性,并检查了现有的诊断方法,重点介绍了 microRNAs 等新型生物标志物。这些生物标志物可以通过非侵入性的液体活检轻松检测到,并可以提供有关正在进行的病理现象的关键信息,特别是在 CDI 中。