Rosenberg J M, Walker M, Welch J P, Mullany L
Am J Surg. 1984 Apr;147(4):486-91. doi: 10.1016/0002-9610(84)90010-2.
The clinical course of 75 patients with diarrhea and positive C. difficile toxin stool assays has been examined. The mean age of the patients was 68 years. Five of 25 surgical nursing units accounted for two thirds of the cases. Many patients were immuno-suppressed with cancer, sepsis, or diabetes mellitus. The median onset of diarrhea was 2.7 days after initial administration of antibiotics. Fever and leukocytosis were frequently seen. Diarrhea ceased in 30 percent of the patients after withdrawal of the offending antibiotics. The remainder required specific therapy with vancomycin, bacitracin, or metronidazole. Two deaths were directly attributable to C. difficile colitis. The hospital stay was prolonged in many patients. C. difficile colitis should be suspected in any patient in whom diarrhea develops during or after a course of antibiotics. Enteric precautions may prevent clustering in these cases and colonization in other susceptible patients.
对75例腹泻且粪便艰难梭菌毒素检测呈阳性的患者的临床病程进行了检查。患者的平均年龄为68岁。25个外科护理单元中有5个单元的病例占了病例总数的三分之二。许多患者因癌症、败血症或糖尿病而免疫抑制。腹泻的中位发病时间是在首次使用抗生素后2.7天。发热和白细胞增多很常见。停用相关抗生素后，30%的患者腹泻停止。其余患者需要用万古霉素、杆菌肽或甲硝唑进行特异性治疗。有两例死亡直接归因于艰难梭菌结肠炎。许多患者的住院时间延长。对于任何在抗生素疗程期间或之后出现腹泻的患者，都应怀疑有艰难梭菌结肠炎。肠道隔离措施可防止这些病例出现聚集现象，并防止其他易感患者定植。
