The challenges posed by reemerging Clostridium difficile infection
The challenges posed by reemerging Clostridium difficile infection
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DOI：
10.1086/518874
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发表时间：
2007-07-15
影响因子：
11.8
通讯作者：
McDonald, L. Clifford
中科院分区：
文献类型：
--
作者：
Blossom, David B.;McDonald, L. Clifford
最近，艰难梭菌相关性疾病(CDAD)的发病率和严重程度显著增加。这可能是因为出现了一种超强毒力的艰难梭菌菌株，它产生了更高水平的毒素A和B，以及一种被称为“二元毒素”的额外毒素。这种以前不常见的菌株已成为流行菌株，与其对氟喹诺酮类药物的耐药性增加不谋而合，氟喹诺酮类药物的使用与CDAD暴发越来越相关。虽然不一定与这种流行毒株有关，但在以前被认为是低风险人群中报告了异常严重的CDAD，包括围产期妇女和居住在社区的健康人。CDAD不断变化的流行病学带来的挑战因目前诊断检测、治疗和感染控制方面的限制而变得更加复杂。克服这些挑战和限制将需要来自各种来源的协调努力，包括传染病临床医生和公共卫生专业人员之间持续的伙伴关系。
There have been recent, marked increases in the incidence and severity of Clostridium difficile-associated disease ( CDAD). These may be attributable to the emergence of a hypervirulent strain of C. difficile that produces increased levels of toxins A and B, as well as an extra toxin known as "binary toxin." This previously uncommon strain has become epidemic, coincident with its development of increased resistance to fluoroquinolones, the use of which is increasingly associated with CDAD outbreaks. Although not necessarily related to this epidemic strain, unusually severe CDAD has been reported in populations that had previously been thought to be at low risk, including peripartum women and healthy persons living in the community. Challenges posed by the changing epidemiology of CDAD are compounded by current limitations in diagnostic testing, treatment, and infection control. Overcoming these challenges and limitations will require a concerted effort from a variety of sources, including an ongoing partnership between infectious disease clinicians and public health professionals.