Clostridium difficile Infection in Special High-Risk Populations.
Clostridium difficile Infection in Special High-Risk Populations.
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DOI：
10.1007/s40121-016-0124-z
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发表时间：
2016-09
影响因子：
5.4
通讯作者：
Cobo, Javier
中科院分区：
文献类型：
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作者：
Cozar-Llisto, Alberto;Ramos-Martinez, Antonio;Cobo, Javier
抗生素的使用仍然是通过破坏结肠固有微生物群而导致艰难梭菌感染 (CDI) 的最重要的危险因素。这一因素加上环境污染，使医院和其他医疗机构成为感染的完美滋生地。几组患者暴露在医院环境中，同时受到可能使 CDI 更普遍、更严重或使其呈现不同临床表现的条件的影响。此类条件的列表似乎过于广泛，无法在一篇文章中进行回顾。尽管如此，包括重症患者、肿瘤患者、实体器官和造血移植受者、炎症性肠病患者、肾病患者和孕妇在内的一些群体引起了更多关注并进行了更详细的研究。另一方面，儿科患者构成了一个有争议的群体，因为大量的无症状携带者使得临床结果和诊断测试的解释变得困难，适当的治疗方法的开发也变得困难。我们对这些高危人群中的 CDI 进行了深入讨论，并回顾了儿科患者中的 CDI 问题。
Antibiotic use continues to be the most important risk factor for the development of Clostridium difficile infection (CDI) through disruption of the indigenous microbiota of the colon. This factor, together with environmental contamination, makes hospital and other healthcare facilities the perfect breeding ground for the infection. Several groups of patients are exposed to the hospital environment and, at the same time, affected by conditions that can make CDI more prevalent, more severe or make it present a different clinical picture. The list of such conditions appears too extensive to be reviewed in a single article. Nevertheless, several groups, including the critically ill, oncological patients, solid organ and hematopoietic transplant recipients, patients with inflammatory bowel disease, patients with kidney disease and pregnant women, have generated more attention and have been studied in more detail. On the other hand, pediatric patients constitute a controversial group because the large number of asymptomatic carriers makes interpretation of clinical findings and diagnostic tests difficult, as is the development of an appropriate approach to treatment. We present an in-depth discussion of CDI in these high-risk populations and we also review the issue of CDI in pediatric patients.