儿童艰难梭菌感染

Clostridium difficile infection in children

随着广谱抗生素的大量使用,艰难梭菌相关性腹泻(CDAD)的发生率明显上升,特别是高毒力株(027/NAP1/BI)在欧美的出现及流行,已经引起全世界的关注。CDAD的临床症状轻重不一,可从轻度腹泻到致死性假膜性肠炎和中毒性巨结肠。CDAD的确诊依赖于实验室检查,包括厌氧菌培养及细胞毒性试验、细菌毒素抗原检测、毒素基因扩增检测。处理包括停用相关抗生素,尽早应用甲硝唑或万古霉素,以及益生菌药物。

With extensive use of broad-spectrum antibiotics, the incidence of clostridium difficile associated diarrhea （CDAD） has increased dramatically. The emergence and outbreak of hypervirulent C. difficile strain （027/ NAP1/B1） in Europe and North American have become a worldwide public concern. CDAD has a wide range of clinical features from mild diarrhea to life-threatening pseudomembrannous colitis and toxic megacolon. The diagnosis of CDAD is dependent on the laboratory assays including anaerobic bacteria culture and cytotoxicity test, toxin antigen detection, and toxin gene amplification. The management of CDAD may include to stop antibiotics being given for other purpose, start the treatment with metronidazole or vancomycin immediately, and use probiotics.