Brettle R P, Poxton I R, Murdoch J M, Brown R, Byrne M D, Collee J G
Br Med J (Clin Res Ed). 1982 Jan 23;284(6311):230-3. doi: 10.1136/bmj.284.6311.230.
A total of 154 patients admitted to an infectious diseases unit were included in a year's prospective survey of sporadic diarrhoeal disease. Stools from 19 of them yielded Clostridium difficile, generally on more than one occasion. Twelve of these patients were assessed as having a severe or moderately severe gastrointestinal illness: Cl difficile was the only pathogen isolated from 10 of them, and two had an associated salmonella infection. Seven had had a recent course of antibiotics, but five had not taken antibiotics. Faeces from seven patients with moderate or mild gastrointestinal illness yielded Cl difficile, and two of these patients also had an associated salmonella infection. Two patients in this group had no antibiotic history. From these findings, the occurrence of C difficile in faeces could not be described as antibiotic-associated. Faecal Cl difficile cytotoxin was detected in only six patients, and generally at low levels. In such patients a more relevant pathogenic index might take account of the numbers of Cl difficile present and of their toxigenic potential.
在一项为期一年的散发性腹泻病前瞻性调查中，纳入了154名入住传染病科的患者。其中19人的粪便培养出艰难梭菌，通常不止一次培养出该菌。这些患者中有12人被评估患有严重或中度严重的胃肠道疾病：其中10人仅分离出艰难梭菌，另外两人伴有沙门氏菌感染。7人近期使用过抗生素疗程，但5人未使用过抗生素。7名患有中度或轻度胃肠道疾病患者的粪便培养出艰难梭菌，其中2人也伴有沙门氏菌感染。该组中有2名患者无抗生素使用史。根据这些发现，粪便中艰难梭菌的出现不能被描述为与抗生素相关。仅在6名患者中检测到粪便艰难梭菌细胞毒素，且通常水平较低。在这类患者中，一个更相关的致病指标可能需要考虑存在的艰难梭菌数量及其产毒潜力。
