CLOSTRIDIUM-DIFFICILE IN RELATION TO ENTERIC BACTERIAL PATHOGENS
CLOSTRIDIUM-DIFFICILE IN RELATION TO ENTERIC BACTERIAL PATHOGENS
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DOI：
10.1128/jcm.12.3.297-300.1980
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发表时间：
1980-01-01
影响因子：
9.4
通讯作者：
SVEDHEM, A
中科院分区：
文献类型：
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作者：
FALSEN, E;KAIJSER, B;SVEDHEM, A
除了标准程序外，所有粪便样本（n = 2390）在 43 天内被送往瑞典哥德堡细菌学实验室，并使用特殊的选择性培养基进行培养以检测艰难梭菌。 2390 个样本中的 81 个样本中发现了艰难梭菌 (3%)。这 81 个样本代表 56 名患者。 56 名患者中有 50 名出现腹泻。 56 名患者中有 20 名（36%）还发现沙门氏菌、弯曲杆菌或耶尔森氏菌。在 2390 个样本中，来自 132 名患者的 252 个样本（11%）显示沙门氏菌、志贺氏菌、弯曲杆菌或耶尔森氏菌呈阳性分离，而仅艰难梭菌的阳性分离率为 3%。该结果表明，通过适当的技术可以轻松分离艰难梭菌。在胃肠炎病例中，经常会同时分离出 1 种以上的细菌病原体，从而发现艰难梭菌。这里提出的理论是，由于抗菌治疗或沙门氏菌等肠道感染等原因引起的正常粪便细菌菌群的任何变化都会增加分离艰难梭菌的可能性。在大多数情况下，艰难梭菌的致病意义可能值得怀疑。大多数腹泻和艰难梭菌感染病例可以自愈，而且并不严重。 56 例中只有 2 例出现严重腹泻，结肠粘膜接触范围扩大，但没有假膜迹象。
All feces samples (n = 2390) sent to the Bacteriological Laboratory, Goteborg, Sweden, over 43 days were, in addition to the standard procedure, cultivated to detect C. difficile by using a special selective medium. C. difficile was found in 81 of the 2390 samples (3%). These 81 samples represented 56 patients. Fifty of the 56 patients had diarrhea. In 20 of the 56 patients (36%), Salmonella, Campylobacter or Yersinia were also found. Of the 2390 samples 252 (11%) from 132 patients revealed positive isolations of Salmonella, Shigella, Campylobacter or Yersinia in comparison to 3% of C. difficile alone. This result suggests that C. difficile can easily be isolated with proper techniques. Concomitant isolations of more than 1 bacterial pathogen in cases of gastroenteritis were often found for C. difficile. The theory presented here is that any change of the normal bacterial fecal flora due to such causes as antimicrobial treatment or enteric infections like Salmonella increases the possibilities of isolating C. difficile. The causative significance of C. difficile might in most cases be doubtful. The majority of cases with diarrhea and C. difficile were self-healing and not severe. Only 2 cases of 56 had severe diarrhea with extended engagement of the colonic mucous membrane, but with no signs of pseudomembranes.