Pathophysiology, Diagnosis and Treatment of Clostridium difficile Infection

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著者

    • CASTAGLIUOLO Ignazio
    • Gastroenterology Division, Beth Israel Deaconess Medical Center, Harvard Medical School
    • THOMAS LAMONT J.
    • Gastroenterology Division, Beth Israel Deaconess Medical Center, Harvard Medical School

抄録

<i>Clostridium difficile</i> infection has become in recent years an important nosocomial threat. Prevention of the spread of <i>C. difficile</i> infection among long term hospitalized patients is a major challenge since <i>C. difficile</i> spores can persist indefinitely in the hospital environment. Following antibiotic therapy that disrupts the normal bacterial flora of the colon, <i>C. difficile</i> can colonize the large intestine. The bacteria releases two large protein toxins that bind to colonocytes and mediate an acute inflammatory diarrhea characterized by an abundant exudate rich in neutrophils and proteins that in some cases can form the typical “pseudomembrane”. <i>C. difficile</i> infection shows a spectrum of severity from asymptomatic carrier to fulminant acute pseudomembranous colitis. The gold standard for the laboratory diagnosis of <i>C. difficile</i> infection is the stool-cytotoxin test, however recently developed immunoassays represent a good alternative. The treatment of <i>C. difficile</i> infection is based on the severity of the clinical picture. In patients with mild diarrhea discontinuation of the causing antibiotic can be an adequate therapeutic approach, whereas patients with more severe symptoms require antibiotic therapy or, in the most severe infections, even colectomy.

収録刊行物

  • Keio journal of medicine

    Keio journal of medicine 48(4), 169-174, 1999-12-01

    The Keio Journal of Medicine

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各種コード

  • NII論文ID(NAID)
    10013620345
  • NII書誌ID(NCID)
    AA00710216
  • 本文言語コード
    ENG
  • 資料種別
    REV
  • ISSN
    00229717
  • データ提供元
    CJP書誌  J-STAGE 
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