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艰难梭菌感染的管理:诊断、治疗及未来展望

Management of Clostridioides difficile Infection: Diagnosis, Treatment, and Future Perspectives.

作者信息

Cymbal Michael, Chatterjee Arjun, Baggott Brian, Auron Moises

机构信息

Department of Internal Medicine, Cleveland Clinic, Cleveland, Ohio.

Department of Gastroenterology, Hepatology & Nutrition, Cleveland Clinic, Cleveland, Ohio.

出版信息

Am J Med. 2024 Jul;137(7):571-576. doi: 10.1016/j.amjmed.2024.03.024. Epub 2024 Mar 18.

Abstract

Clostridioides difficile infection is the most common healthcare-associated infection in the United States, with potential life-threatening complications and a significant impact on the costs of care. Antibiotic stewardship as well as discontinuation of chronic acid suppressive therapy are key for its prevention and treatment. Effective infection management requires appropriate interpretation of diagnostic tests, as well as the use of vancomycin and fidaxomicin as first-line treatment. Novel treatments such as Bezlotoxumab, fecal microbiota transplant, and live biotherapeutic products are proven effective in recurrent C. difficile infection and address dysbiosis.

摘要

艰难梭菌感染是美国最常见的医疗保健相关感染,具有潜在的危及生命的并发症,并且对护理成本有重大影响。抗生素管理以及停用慢性酸抑制疗法是其预防和治疗的关键。有效的感染管理需要对诊断测试进行适当解读,以及使用万古霉素和非达霉素作为一线治疗药物。诸如贝佐妥单抗、粪便微生物群移植和活生物治疗产品等新型治疗方法已被证明对复发性艰难梭菌感染有效,并可解决生态失调问题。

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