Colitis induced by Clostridium difficile.
Colitis induced by Clostridium difficile.
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由艰难梭菌引起的结肠炎。
DOI：
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发表时间：
1979
期刊：
影响因子：
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通讯作者：
Andrew B. Onderdonk
中科院分区：
文献类型：
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作者：
John G. Bartlett;Tewen Chang;Naney S. Taylor;Andrew B. Onderdonk
艰难梭菌被认为是抗生素相关性伪膜性结肠炎的主要原因。目前选择的实验室诊断试验是一种组织培养试验，证明存在一种细胞病变毒素，该毒素被索氏梭菌的抗毒素中和。这种毒素在43名抗生素相关性伪膜性结肠炎患者中的42名患者和78名抗生素相关性腹泻患者中的12名患者的粪便中发现。与使用抗生素无关的胃肠道疾病患者和健康对照组的样本均为阴性。由于艰难梭菌的肉汤培养物中也含有一种被该抗毒素中和的细胞病变毒素，因此抗毒素对索氏梭菌的中和毒素似乎代表了抗原交叉反应。艰难梭菌菌株对万古霉素敏感，口服这种药物的初步临床经验显示出有希望的结果。
Clostridium difficile has been implicated as the major cause of antibiotic-associated pseudomembranous colitis. The current laboratory diagnostic test of choice is a tissue culture assay that demonstrates the presence of a cytopathic toxin neutralized by antitoxin to Clostridium sordellii. This toxin was found in stools from 42 of 43 patients with antibiotic-associated pseudomembranous colitis and in stools from 12 of 78 patients with antibiotic-associated diarrhea. Specimens from patients with gastrointestinal conditions unrelated to administration of antibiotics and those from healthy controls were uniformly negative. Neutralization of toxin by antitoxin to C. sordellii appears to represent antigenic cross-reactivity, since broth cultures of C. difficile also contain a cytopathic toxin neutralized by this antitoxin. Strains of C. difficile are susceptible to vancomycin, and the initial clinical experience with oral administration of this agent shows promising results.