Identification of Toxemia in Patients with Clostridium difficile Infection
Identification of Toxemia in Patients with Clostridium difficile Infection
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DOI：
10.1371/journal.pone.0124235
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发表时间：
2015-04-17
期刊：
影响因子：
3.7
通讯作者：
Feng, Hanping
中科院分区：
文献类型：
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作者：
Yu, Hua;Chen, Kevin;Feng, Hanping
毒血症可在艰难梭菌感染的动物中发展，并与严重和暴发性疾病结局相关。间接证据表明，C。艰难梭菌感染（CDI），但阳性诊断是非常罕见的。我们分析了C.艰难梭菌毒血症患者，确定其特点，并评估挑战。C.使用基于超灵敏细胞的测定法测试来自患者的血清中的艰难梭菌毒素，并通过Rac 1葡糖基化测定法进一步证实。对影响毒血症诊断的因素进行了评估，包括毒素稳定性的调查、血清中毒素特异性中和抗体的水平及其对诊断界限的影响。CDI患者在某些情况下出现可检测到的毒血症（2.3%）。毒素在储存的血清中相对稳定。中和抗毒素抗体存在于感染过程中，与诊断界限呈正相关。因此，毒素特异性中和抗体的掩蔽效应是诊断C。艰难梭菌毒血症的研究。
Toxemia can develop in Clostridium difficile-infected animals, and correlates with severe and fulminant disease outcomes. Circumstantial evidence suggests that toxemia may occur in patients with C. difficile infection (CDI), but positive diagnosis is extremely rare. We analyzed the potential for C. difficile toxemia in patients, determined its characteristics, and assessed challenges. C. difficile toxins in serum from patients were tested using an ultrasensitive cell-based assay and further confirmed by Rac1 glucosylation assay. The factors that hinder a diagnosis of toxemia were assessed, including investigation of toxin stability, the level of toxins-specific neutralizing antibodies in sera and its effect on diagnosis limits. CDI patients develop detectable toxemia in some cases (2.3%). Toxins were relatively stable in stored sera. Neutralizing anti-toxin antibodies were present during infection and positively correlated with the diagnosis limits. Thus, the masking effect of toxin-specific neutralizing antibodies is the major obstacle in diagnosing C. difficile toxemia using cell-based bioassays.