BI/NAP1/027型高产毒艰难拟梭菌的研究现状与展望

Research status and prospect of hypervirulent Clostridioides difficile strain BI/NAP1/027

艰难拟梭菌是一种普遍存在于人体肠道中的条件致病菌。当机体在各种诱因下出现菌群失调时,艰难拟梭菌可通过释放其特有的毒素而诱发肠道炎症反应,使患者出现从单纯的腹泻到致命的感染性休克等多种轻重不等的临床症状。近几年,我国多地陆续从患者的粪便样本中检测到BI/NAP1/027型艰难拟梭菌。该型菌株能产生更高水平的毒素和更难杀灭的芽孢,一旦暴发传播,将给全球公共卫生安全带来巨大的威胁和挑战。结合目前国内外已有的研究成果和病例报道,对BI/NAP1/027型高产毒艰难拟梭菌的流行病学特征、毒力与致病机制、分子诊断技术和治疗方式等进行归纳总结,并展望了领域内未来的研究热点和努力方向,并为日后更深入地解析其致病机制和更科学地拟定其防治方案提供了理论依据。

Clostridioides difficile is a kind of opportunistic pathogen ubiquitous in human intestinal tracts.It can induce intestinal inflammation by releasing its unique toxins when the body has dysbacteriosis due to various triggers,causing patients to experience a variety of clinical symptoms ranging from simple diarrhea to fatal septic shock.In recent years,the BI/NAP1/027 strain of Clostridioidesdifficile has been detected in stool samples of patients from medical institutions all around China.This kind of strain can produce higher levels of toxins and spores that are more difficult to eradicate.More importantly,the strain will pose tremendous threats and challenges to global public health security once it spreads.In this paper,the epidemiological characteristics,virulence,pathogenic mechanisms,molecular diagnostic techniques and the treatment methods of hypervirulent Clostridioides difficile strain BI/NAP1/027 were summarized based on the existing research results and case reports at home and abroad.The possible future research hotspots and endeavors in the field have also been suggested.This article aimed to make a comprehensive understanding of hypervirulent Clostridioides difficile strain BI/NAP1/027,and to provide a theoretical basis for more in-depth analysis of its pathogenic mechanism and more scientific formulation of its prevention and treatment plans in the future.