Medical Development and Scientific/Clinical Affairs, Vaccines, Antivirals, and Evidence Generation, Pfizer Inc., 500 Arcola Rd., Collegeville, PA, 19426, USA.
Pfizer Ltd 70, G Block Rd, Bandra Kurla Complex, Mumbai, Maharashtra 400051, India.
Anaerobe. 2024 Apr;86:102821. doi: 10.1016/j.anaerobe.2024.102821. Epub 2024 Feb 7.
Clostridioides difficile (formerly Clostridium difficile) is well-documented in Europe and North America to be a common cause of healthcare-associated gastrointestinal tract infections. In contrast, C difficile infection (CDI) is infrequently reported in literature from Asia, which may reflect a lack of clinician awareness. We conducted a narrative review to better understand CDI burden in Asia.
We searched the PubMed database for English language articles related to C difficile, Asia, epidemiology, and molecular characteristics (eg, ribotype, antimicrobial resistance).
Fifty-eight articles that met eligibility criteria were included. C difficile prevalence ranged from 7.1% to 45.1 % of hospitalized patients with diarrhea, and toxigenic strains among all C difficile in these patients ranged from 68.2% to 91.9 % in China and from 39.0% to 60.0 % outside of China. Widespread C difficile ribotypes were RT017, RT014/020, RT012, and RT002. Recurrence in patients with CDI ranged from 3.0% to 17.2 %. Patients with CDI typically had prior antimicrobial use recently. High rates of resistance to ciprofloxacin, clindamycin, and erythromycin were frequently reported.
The regional CDI burden in Asia is still incompletely documented, seemingly due to low awareness and limited laboratory testing. Despite this apparent under recognition, the current CDI burden highlights the need for broader surveillance and for application of preventative measures against CDI in Asia.
艰难梭菌（以前称为艰难梭菌）在欧洲和北美有大量文献记载，是与医疗保健相关的胃肠道感染的常见病因。相比之下，亚洲文献中很少报道艰难梭菌感染（CDI），这可能反映出临床医生对此认识不足。我们进行了一项叙述性综述，以更好地了解亚洲 CDI 的负担。
我们在 PubMed 数据库中搜索了与艰难梭菌、亚洲、流行病学和分子特征（例如，核糖体分型、抗微生物药物耐药性）相关的英文文章。
符合入选标准的 58 篇文章被纳入。腹泻住院患者中艰难梭菌的流行率为 7.1%至 45.1%，这些患者中所有艰难梭菌的产毒菌株比例在中国为 68.2%至 91.9%，在除中国外的其他地区为 39.0%至 60.0%。广泛流行的艰难梭菌核糖体分型为 RT017、RT014/020、RT012 和 RT002。CDI 患者的复发率为 3.0%至 17.2%。CDI 患者通常有近期使用过抗微生物药物。频繁报告对环丙沙星、克林霉素和红霉素的耐药率很高。
亚洲地区 CDI 的负担仍未完全记录，这似乎是由于认识水平低和实验室检测有限所致。尽管这种明显的认识不足，但目前 CDI 的负担凸显了在亚洲更广泛地监测和应用 CDI 预防措施的必要性。
