Pathogenicity and virulence of Clostridioides difficile.
Pathogenicity and virulence of Clostridioides difficile.
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DOI：
10.1080/21505594.2022.2150452
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发表时间：
2023-12
期刊：
影响因子：
5.2
通讯作者：
中科院分区：
文献类型：
--
作者：
艰难梭状芽胞杆菌是引起院内抗生素相关性腹泻的最常见原因，是一系列以高复发率、发病率和死亡率为特征的疾病的罪魁祸首。治疗是复杂的，因为抗生素既是主要的治疗方法，也是感染的主要风险因素。令人担忧的是，对多种抗生素的抗药性正变得越来越普遍，导致这种病原体被归类为对全球健康的紧迫威胁。作为一个完美的机会主义者，艰难梭菌由于其毒力因子的武器库，为促进疾病做好了准备：由于形成了强大的内孢子，这种厌氧菌的传播效率很高，而且一系列粘附素促进了肠道定植。艰难梭菌产生多种毒素作用于肠道上皮细胞，导致腹泻疾病的典型表现，以及部分患者的严重炎症。本文综述了这些毒力因子，以及抗菌素耐药性和基因组可塑性在这种重要病原菌的致病机制和持久性中的重要性。
Clostridioides difficile is the most common cause of nosocomial antibiotic-associated diarrhea, and is responsible for a spectrum of diseases characterized by high levels of recurrence, morbidity, and mortality. Treatment is complex, since antibiotics constitute both the main treatment and the major risk factor for infection. Worryingly, resistance to multiple antibiotics is becoming increasingly widespread, leading to the classification of this pathogen as an urgent threat to global health. As a consummate opportunist, C. difficile is well equipped for promoting disease, owing to its arsenal of virulence factors: transmission of this anaerobe is highly efficient due to the formation of robust endospores, and an array of adhesins promote gut colonization. C. difficile produces multiple toxins acting upon gut epithelia, resulting in manifestations typical of diarrheal disease, and severe inflammation in a subset of patients. This review focuses on such virulence factors, as well as the importance of antimicrobial resistance and genome plasticity in enabling pathogenesis and persistence of this important pathogen.
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