Ubsdell Daisy, Maddox Nicola Louise, Sheridan Ray
Royal Devon University Healthcare NHS Foundation Trust, Exeter, UK.
Royal Devon University Healthcare NHS Foundation Trust and North Bristol NHS Trust, Bristol, UK.
J Med Microbiol. 2025 Apr;74(4). doi: 10.1099/jmm.0.001991.
(formerly known as ) is a significant cause of healthcare-associated infection with symptoms ranging from diarrhoea and abdominal pain to pseudomembranous colitis and toxic megacolon. Severe disease can pose a significant morbidity and mortality risk and is to be considered a medical emergency. The emergence of a new ribotype with an estimated mortality rate of 20% (ribotype 995) has prompted a re-review of the evidence and guidelines around managing severe infections (CDI). International guidance on the management of CDI varies regarding first-line antibiotic choice. Metronidazole is no longer favoured as first line due to concerns around resistance, and vancomycin and fidaxomicin are now recommended as first line options. Antibiotic therapy should be used in conjunction with good supportive measures and early consideration of surgical management. Faecal microbiota transplant can be utilized in recurrent CDI and may be useful in severe disease. Severe CDI is a significant ongoing threat to public health, and further research into effective management is essential to ensure the best possible outcomes for patients.
（以前称为 ）是医疗相关感染的一个重要原因，症状从腹泻和腹痛到伪膜性结肠炎和中毒性巨结肠不等。严重疾病可带来重大的发病和死亡风险，应被视为医疗紧急情况。一种估计死亡率为20%的新型核糖体分型（核糖体分型995）的出现促使人们重新审视关于严重感染（艰难梭菌感染）管理的证据和指南。关于艰难梭菌感染管理的国际指南在一线抗生素选择方面存在差异。由于对耐药性的担忧，甲硝唑不再被视为一线用药，现在推荐万古霉素和非达霉素作为一线选择。抗生素治疗应与良好的支持措施以及早期考虑手术管理相结合。粪便微生物群移植可用于复发性艰难梭菌感染，对严重疾病可能也有用。严重艰难梭菌感染对公众健康仍然构成重大持续威胁，进一步开展有效管理方面的研究对于确保患者获得最佳可能结果至关重要。
