PREVENTION OF FURTHER RECURRENCES OF CLOSTRIDIUM-DIFFICILE COLITIS WITH SACCHAROMYCES-BOULARDII
PREVENTION OF FURTHER RECURRENCES OF CLOSTRIDIUM-DIFFICILE COLITIS WITH SACCHAROMYCES-BOULARDII
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DOI：
10.1007/bf01536805
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发表时间：
1990-07-01
影响因子：
3.1
通讯作者：
MCFARLAND, LV
中科院分区：
文献类型：
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作者：
KIMMEY, MB;ELMER, GW;MCFARLAND, LV
一个病人有六个记录的复发性艰难梭菌结肠炎发作超过八个月的时间内描述。尽管使用万古霉素、甲硝唑、杆菌肽和考来烯胺治疗，但仍发生结肠炎复发。每次复发似乎都在接近前一疗程结束时开始开始。四次发作严重到需要住院补液，布拉酵母菌，一种非致病性酵母菌，在最后一次复发停止万古霉素治疗前开始，并持续了三个月。连续粪便培养和C. difficult显示了微生物的持久性，但细胞毒素的高滴度迅速降低。在患者服用布拉酵母菌期间，并在停用酵母菌后随访18个月，未发生腹泻或结肠炎的进一步复发。
A patient with six documented episodes of recurrentClostridium difficilecolitis over an eight-month period is described. Relapses of colitis occurred despite treatment with vancomycin, metronidazole, bacitracin, and cholestyramine. Each recurrence appeared to begin successively closer to the end of the previous course of treatment. Four episodes were sufficiently severe to require hospitalization for rehydration.Saccharomyces boulardii, a nonpathogenic yeast, was begun prior to discontinuing vancomycin therapy for the last recurrence and was continued for three months. Serial stool cultures and assays forC. difficileshowed persistence of the organism but rapid reduction of high titers of cytotoxin. No further recurrences of diarrhea or colitis were encountered while the patient was takingSaccharomyces boulardiiand for 18 months of follow-up after the yeast was discontinued.