George W L, Rolfe R D, Harding G K, Klein R, Putnam C W, Finegold S M
Infection. 1982;10(4):205-8. doi: 10.1007/BF01666910.
Thirty patients with antimicrobial agent-associated pseudomembranous colitis (PMC) were studied for the presence of Clostridium difficile and its cytotoxin in feces. Either colonoscopy or barium enema radiography was required in three patients for the diagnosis of PMC because of nondiagnostic findings at sigmoidoscopy. Both the organism and cytotoxin were detected in 27 of the 30 patients; Staphylococcus aureus was excluded as the cause of PMC in two of the remaining patients. Eighteen of 19 patients with C. difficile-induced PMC who were treated with oral vancomycin had a salutary response; seven patients, however, had a relapse of colitis following the discontinuation of vancomycin. In general, relapses of colitis responded to retreatment with vancomycin. The implication of C. difficile as a cause of diarrhea is best achieved by the demonstration of colonic mucosal plaques or of a pseudomembrane. The value of fecal culture for C. difficile and cytotoxin assay is limited by the existence of asymptomatic carriers.
对30例抗菌药物相关性假膜性结肠炎（PMC）患者的粪便进行艰难梭菌及其细胞毒素检测。3例患者因乙状结肠镜检查无诊断性发现，需行结肠镜检查或钡剂灌肠造影以诊断PMC。30例患者中27例检测到该菌及细胞毒素；其余2例患者排除金黄色葡萄球菌为PMC病因。19例接受口服万古霉素治疗的艰难梭菌所致PMC患者中，18例有良好反应；然而，7例患者在停用万古霉素后结肠炎复发。一般来说，结肠炎复发对再次使用万古霉素治疗有反应。通过显示结肠黏膜斑块或假膜，最能说明艰难梭菌是腹泻的病因。无症状携带者的存在限制了艰难梭菌粪便培养和细胞毒素检测的价值。
