Clostridioides difficile Infection in the Stem Cell Transplant and Hematologic Malignancy Population.
Clostridioides difficile Infection in the Stem Cell Transplant and Hematologic Malignancy Population.
复制标题
干细胞移植和血液恶性肿瘤人群中的艰难梭菌感染。
DOI：
10.1016/j.idc.2019.02.010
复制
发表时间：
2019
影响因子：
4.4
通讯作者：
Safdar,Nasia
中科院分区：
文献类型：
--
作者：
Misch,ElizabethAnn;Safdar,Nasia
Clostridioides difficile (CD)(previously known as Clostridium difficile) is an anaerobic, Gram-positive, spore-forming bacillus that is widespread in the natural environment (found in soils, puddle water, tap water, household surfaces, food, horses, and hay, among other sites), but whose main habitat is the gastrointestinal tract of young mammals. 1–3 CD colonizes the gut of up to 70% of neonates and infants and can form part of the commensal intestinal flora of asymptomatic adults. 4 However, since 1978, when it was first described as clindamycin colitis or antibiotic-associated pseudomembranous colitis, CD has been recognized to cause a spectrum of human disease, ranging from mild diarrhea to severe illness and fulminant colitis, associated with ileus and bowel dilatation (megacolon), bowel perforation, and septic shock. 5–9 Between 2000 and 2005, a hypervirulent strain of CD, known as North American pulsed-field gel electrophoresis type 1, restriction endonuclease analysis group BI, and polymerase chain reaction (PCR) ribotype 027 (NAP1/BI/027) spread globally. 10–12 The NAP1/027 strain is associated with increased toxin A and B production, produces binary toxin, and is fluoroquinolone-resistant. It harbors a deletion mutation in the TcdC gene (a negative regulator of toxin A and B transcription) that is thought to permit increased toxin production. 10, 11 Coincident with the global emergence of NAP1/027, increasing reports of CD infection (CDI) in the stem cell transplant (SCT) and hematologic malignancy (HM) populations appeared in the literature. 13–22
