炎症性肠病患者艰难梭菌感染研究进展

Research progress of clostridium difficile infection in patients with inflammatory bowel disease

艰难梭菌(clostridium difficile,CD)是抗生素相关性腹泻的常见病原体,炎症性肠病(inflammatory bowel disease,IBD)患者有较高的CD感染发病率,其易患因素包括:患者高龄、合并基础疾病、IBD本身、社区感染,以及抗生素、质子泵抑制剂、免疫抑制剂的使用。IBD患者合并CDI的临床表现与IBD病情加重难以区分。检测谷氨酸脱氢酶,进而通过酶免疫分析法对CD毒素进行检验有利于确诊CD感染。甲硝唑、万古霉素、非达霉素等都可用于CD感染治疗,粪菌移植是一种新兴的治疗CD感染的方法。

Clostridium difficile(CD)is a common pathogen of antibiotic associated diarrhea.Patients with inflammatory bowel disease(IBD)havea high prevalence of CD infection(CDI).The risk factors include advancedage,combined underlying diseases,IBD itself,community infection,antibiotics,proton pump inhibitors and the use of immunosuppressive agents.It’s difficult to distinguish IBD patients with CDI and aggravated IBD by clinical manifestation.Detecting glutamate dehydrogenase and enzyme immunoassay for CD toxin are helpful to the diagnosis of CDI.Metronidazole,vancomycin,fidaxomicin,etc.can be used for CDI treatment.Fecal bacteria transplantation(FMT)is a new therapy for CDI.