Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China.
Characteristics and management of children with Clostridioides difficile infection at a tertiary pediatric hospital in China.
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我国某三甲儿科医院艰难梭菌感染患儿的特点及处理
DOI：
10.1016/j.bjid.2022.102380
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发表时间：
2022-07
影响因子：
3.4
通讯作者：
Zhang, Ting
中科院分区：
文献类型：
--
作者：
Li, Xiaolu;Xiao, Fangfei;Li, Youran;Hu, Hui;Xiao, Yongmei;Xu, Qiao;Li, Dan;Yu, Guangjun;Wang, Yizhong;Zhang, Ting
艰难梭菌感染（CDI）是儿童抗生素相关性腹泻的最常见原因之一。常规抗生素和新出现的粪便微生物群移植（FMT）用于治疗CDI。2014年9月至2020年9月在上海儿童医院住院的CDI患儿被回顾性纳入本观察性研究。将儿童患者分为初始CDI和复发CDI (RCDI)，系统地记录和分析症状、合并症、影像学表现、实验室检查和治疗。109例小儿CDI患者中，58例为男孩（53.2%），中位年龄为5岁（范围2-9岁）。CDI患儿的主要临床症状为腹泻（109/109,100%）、便血（55/109,50.46%）、腹痛（40/109,36.70%）；发热39例（35.78%）、假膜33例（30.28%）、胃胀24例（22.02%）。常规抗生素为主治疗，甲硝唑68例，万古霉素41例。甲硝唑组RCDI发生率为48.53%(33/68)，万古霉素组为46.33% (19/41)（p=0.825）。RCDI患儿FMT总解决率显著高于万古霉素治疗组（28/29,96.55% vs 11/23, 47.83%, p < 0.001）。FMT治疗2个月后无严重不良事件（SAEs）报告。CDI患儿主要表现为腹泻、便血、腹痛。FMT治疗小儿RCDI的治愈率优于万古霉素治疗。
Clostridiodes difficile infection (CDI) is one of the most common causes of antibiotic-associated diarrhea in children. Conventional antibiotics and emerging fecal microbiota transplantation (FMT) are used to treat CDI. Children with CDI admitted to the Shanghai Children's Hospital, from September 2014 to September 2020, were retrospectively included to this observational study. Pediatric patients were assigned as initial CDI and recurrent CDI (RCDI), and symptoms, comorbidities, imaging findings, laboratory tests, and treatments were systematically recorded and analyzed. Of 109 pediatric patients with CDI, 58 were boys (53.2%), and the median age was 5 years (range, 2-9 years). The main clinical symptoms of CDI children were diarrhea (109/109, 100%), hematochezia (55/109, 50.46%), abdominal pain (40/109, 36.70%); fever, pseudomembrane, vomit, and bloating were observed in 39 (35.78%), 33 (30.28%), and 24 (22.02%) patients, respectively. For the primary therapy with conventional antibiotics, 68 patients received metronidazole, and 41 patients received vancomycin. RCDI occurred in 48.53% (33/68) of those initially treated with metronidazole compared with 46.33% (19/41) of those initially treated with vancomycin (p=0.825). The total resolution rate of FMT for RCDI children was significantly higher than with vancomycin treatment (28/29, 96.55% vs 11/23, 47.83%, p < 0.001). There were no serious adverse events (SAEs) reported after two months of FMT. The major manifestations of children with CDI were diarrhea, hematochezia, and abdominal pain. The cure rate of FMT for pediatric RCDI is superior to vancomycin treatment.
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复发性艰难梭菌感染儿童粪便微生物移植后的临床疗效和微生物组变化
影响因子：
5.2
作者：
Li X;Gao X;Hu H;Xiao Y;Li D;Yu G;Yu D;Zhang T;Wang Y
通讯作者：
Wang Y
美国梭菌艰难梭菌感染和结果负担的趋势。
DOI：
10.1056/nejmoa1910215
发表时间：
2020-04-02
期刊：
The New England journal of medicine
影响因子：
--
作者：
Guh AY;Mu Y;Winston LG;Johnston H;Olson D;Farley MM;Wilson LE;Holzbauer SM;Phipps EC;Dumyati GK;Beldavs ZG;Kainer MA;Karlsson M;Gerding DN;McDonald LC;Emerging Infections Program Clostridioides difficile Infection Working Group
通讯作者：
Emerging Infections Program Clostridioides difficile Infection Working Group
影响因子：
3.6
作者：
Malmqvist, Lovisa;Ullberg, Mans;Nilsson, Anna
通讯作者：
Nilsson, Anna
影响因子：
11.8
作者：
McDonald, L. Clifford;Gerding, Dale N.;Wilcox, Mark H.
通讯作者：
Wilcox, Mark H.
DOI：
10.1056/nejmra0707500
发表时间：
2008-10-30
期刊：
The New England journal of medicine
影响因子：
--
作者：
Kelly, Ciaran P;LaMont, J Thomas
通讯作者：
LaMont, J Thomas