背景:艰难梭菌感染(CDI)是一种常见的医院感染。发生CDI的危险因素包括既往住院,年龄超过65岁,抗生素使用,和慢性疾病。它与腹泻和结肠炎有关,严重程度可能有所不同。它是住院患者发病率和死亡率增加的主要原因。然而,社区获得的CDI也在增加。正确的诊断和严重程度的确定对于CDI的治疗至关重要。根据CDI的严重程度,患者可能认可不同的症状和体格检查结果。CDI的严重程度将决定其治疗的积极程度。管理和治疗:实验室研究有助于CDI的诊断。在这方面,普通实验室包括全血细胞计数,粪便化验,and,在某些情况下,射线照相和内窥镜检查。轻中度结肠炎用抗生素治疗,但是严重的结肠炎需要不同的方法,其中可能包括手术。存在用于CDI的几种替代疗法并且已经显示出有希望的结果。这篇综述将涉及这些疗法,其中包括粪便移植,静脉注射免疫球蛋白,以及使用消胆胺和替加环素。
结论:可以通过适当的卫生来预防CDI,疫苗接种,及早发现感染。适当的卫生确实被认为是在医院环境中预防CDI的最佳方法之一。抗生素处方过量也是CDI发生的另一个重要原因。适当的抗生素处方也可以帮助减少获得CDI的机会。
BACKGROUND: Clostridioides difficile infection (CDI) is a common nosocomial infection. Risk factors for developing CDI include prior hospitalization, being older than 65 years old, antibiotic use, and chronic disease. It is linked with diarrhea and colitis and can vary in severity. It is a major cause of increased morbidity and mortality among hospitalized patients. However, community-acquired CDI is also increasing. Proper diagnosis and determination of severity are crucial for the treatment of CDI. Depending on how severe the CDI is, the patient may endorse different symptoms and physical exam findings. The severity of CDI will determine how aggressively it is treated. Management and treatment: Laboratory studies can be helpful in the diagnosis of CDI. In this regard, common labs include complete blood count, stool assays, and, in certain cases, radiography and endoscopy. Mild-to-moderate colitis is treated with antibiotics, but severe colitis requires a different approach, which may include surgery. Several alternative therapies for CDI exist and have shown promising results. This
review will touch upon these therapies, which include fecal transplants, intravenous immunoglobulin, and the use of cholestyramine and tigecycline.
CONCLUSIONS: Prevention of CDI can be achieved by proper hygiene, vaccinations, and detecting the infection early. Proper hygiene is indeed noted to be one of the best ways to prevent CDI in the hospital setting. Overprescribing antibiotics is also another huge reason why CDI occurs. Proper prescription of antibiotics can also help reduce the chances of acquiring CDI.