Levine H G, Lamont J T
Compr Ther. 1982 Aug;8(8):36-43.
C. difficile, a gram-positive anaerobic bacillus, has emerged in the past five years as a common cause of hospital-acquired diarrhea. The organism usually gains entry to the host during or after antibiotic treatment, which presumably alters the normal barrier function of the colonic microflora. The organism produces a cytotoxin that can be identified in stool samples by its ability to alter the cellular morphology of tissue culture cells. Infection with C. difficile produces a spectrum of diseases ranging from mild diarrhea to fulminating colitis. An important bedside clue is the presence of pseudomembranes in the rectum or sigmoid at proctosigmoidoscopy. The disease may also occur in patients with chronic inflammatory bowel disease where it may be confused with a relapse of the underlying disease. Treatment with vancomycin is effective, but 10% to 15% of patients may experience relapse. The major mode of transmission appears to be environmental acquisition rather than person-to-person spread.
艰难梭菌是一种革兰氏阳性厌氧芽孢杆菌，在过去五年中已成为医院获得性腹泻的常见病因。该病原体通常在抗生素治疗期间或之后进入宿主，这可能会改变结肠微生物群的正常屏障功能。该病原体产生一种细胞毒素，可通过其改变组织培养细胞的细胞形态的能力在粪便样本中识别出来。艰难梭菌感染会引发一系列疾病，从轻度腹泻到暴发性结肠炎。一个重要的床边线索是在直肠乙状结肠镜检查时直肠或乙状结肠存在假膜。该疾病也可能发生在慢性炎症性肠病患者中，可能会与基础疾病的复发相混淆。用万古霉素治疗是有效的，但10%至15%的患者可能会复发。主要传播方式似乎是环境感染而非人传人。
