Bartlett J G, Chang T, Taylor N S, Onderdonk A B
Rev Infect Dis. 1979 Mar-Apr;1(2):370-8. doi: 10.1093/clinids/1.2.370.
Clostridium difficile has been implicated as the major cause of antibiotic-associated pseudomembranous colitis. The current laboratory diagnostic test of choice is a tissue culture assay that demonstrates the presence of a cytopathic toxin neutralized by antitoxin to Clostridium sordellii. This toxin was found in stools from 42 of 43 patients with antibiotic-associated pseudomembranous colitis and in stools from 12 of 78 patients with antibiotic-associated diarrhea. Specimens from patients with gastrointestinal conditions unrelated to administration of antibiotics and those from healthy controls were uniformly negative. Neutralization of toxin by antitoxin to C. sordellii appears to represent antigenic cross-reactivity, since broth cultures of C. difficile also contain a cytopathic toxin neutralized by this antitoxin. Strains of C. difficile are susceptible to vancomycin, and the initial clinical experience with oral administration of this agent shows promising results.
艰难梭菌被认为是抗生素相关性假膜性结肠炎的主要病因。目前实验室诊断的首选检测方法是组织培养试验，该试验可证明存在一种被索氏梭菌抗毒素中和的细胞病变毒素。在43例抗生素相关性假膜性结肠炎患者中的42例粪便中以及78例抗生素相关性腹泻患者中的12例粪便中发现了这种毒素。来自与抗生素使用无关的胃肠道疾病患者的标本以及健康对照者的标本均为阴性。索氏梭菌抗毒素对毒素的中和似乎代表抗原交叉反应，因为艰难梭菌的肉汤培养物中也含有一种被该抗毒素中和的细胞病变毒素。艰难梭菌菌株对万古霉素敏感，口服该药物的初步临床经验显示出有希望的结果。
