Diagnosis and Treatment of Clostridium difficile Infection (CDI).
Diagnosis and Treatment of Clostridium difficile Infection (CDI).
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DOI：
10.1097/ipc.0000000000000350
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发表时间：
2016-01
期刊：
影响因子：
--
通讯作者：
McDonald LC
中科院分区：
文献类型：
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作者：
Gerding DN;File TM Jr;McDonald LC
早期和准确的诊断对于艰难梭菌感染（CDI）患者的最佳治疗和实施有效的感染控制程序至关重要。关于使用哪种诊断测试的决定是一个重要的决定，应该基于测试的灵敏度，特异性和预测值。CDI的挑战不仅仅是快速识别和管理有症状的患者。长期以来，C.这是一种艰难的传播，但它可能发挥更大的作用比以前认为的。新出现的信息还表明，接受CDI治疗的患者在症状缓解后仍会在体内定植数周。事实上，粪便培养阳性率在治疗完成后的第一周内增加。减少无症状脱落的持续时间和程度的治疗可能会增加减少传播的益处。
Early and accurate diagnosis is essential for optimal treatment of individuals with Clostridium difficile infection (CDI) and for implementation of effective infection control procedures. The decision about which diagnostic test to use is an important one that should be based on test sensitivity, specificity, and predictive value. The challenges of CDI go beyond rapid identification and management of symptomatic patients. Asymptomatic carriage has long been suspected in C. difficile transmission, but it may play a larger role than previously thought. Emerging information also shows that patients treated for CDI remain colonized for many weeks after symptom resolution. In fact, stool culture positivity increases during the first weeks following treatment completion. Treatments that reduce the duration and degree of asymptomatic shedding could have added benefit for reduced transmission.