Weymann L H
Am J Med Technol. 1982 Nov;48(11):927-34.
Recent evidence has incriminated a toxin-producing anaerobe, Clostridium difficile, as the causative agent of pseudomembranous colitis, an acute inflammatory bowel disease that generally occurs in association with antimicrobial therapy. A wide variety of antimicrobial agents appear to promote C. difficile infection and thereby precipitate colitis. Although the exact pathogenetic mechanisms are not known, several hypotheses, related to the ability of antibiotics to suppress competing bacteria and alter bacterial adhesion to intestinal mucosa, are explored in this review. Laboratory participation in the diagnosis of pseudomembranous colitis caused by C. difficile involves culture and toxin assay. Isolation of C. difficile from feces is facilitated by the use of recently developed selective media. Vancomycin is recommended for treatment of pseudomembranous colitis when removal of the offending antimicrobial agent does not result in clinical improvement.
最近有证据表明，一种产毒素的厌氧菌——艰难梭菌，是伪膜性结肠炎的病原体，伪膜性结肠炎是一种急性炎症性肠病，通常与抗菌治疗有关。各种各样的抗菌药物似乎都能促进艰难梭菌感染，从而引发结肠炎。尽管确切的发病机制尚不清楚，但本综述探讨了几种与抗生素抑制竞争性细菌和改变细菌对肠黏膜黏附能力相关的假说。实验室参与艰难梭菌引起的伪膜性结肠炎的诊断包括培养和毒素检测。使用最近开发的选择性培养基有助于从粪便中分离出艰难梭菌。当停用引起问题的抗菌药物后临床症状无改善时，推荐使用万古霉素治疗伪膜性结肠炎。
