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艰难梭菌是一种非常重要的医院感染病原菌,其感染占抗菌素相关腹泻的10-25%,占抗菌素相关肠炎的50-75%,占抗菌素相关伪膜炎的90-100%。而且越来越多的证据表明艰难梭菌的感染与其它疾病,如活性关节炎、婴儿突发性死亡、溶血性尿毒症、坏死性肠炎、希施斯普龙病等有关。更糟糕的是艰难梭菌存在着复发性感染,15-20%的病人在成功治愈后会复发。近年来,随着强毒株的出现,艰难梭菌的感染率和发病率逐年上升,病情也越来越严重,由艰难梭菌感染引起的死亡率也成倍增加。到目前为止,艰难梭菌发病率升高的原因及其致病机制还有待进一步研究。由于艰难梭菌是一种孢子产生菌,对大部分抗菌素都有抗性,目前用于艰难梭菌防治的主要抗菌素甲硝唑和万古霉素的治疗效果也在不断下降,所以正确认识艰难梭菌的感染与流行,进一步了解其致病机制,寻找新的替代疗法已是迫在眉睫。本文对艰难梭菌感染和流行的病因进行了较为全面的分析,对其致病机制进行了深入的总结,并探讨了艰难梭菌防治的最新策略和方法,将有利于更好的认识和研究艰难梭菌,为艰难梭菌的防治提供新思路。
C. difficile is a very important nosocomial pathogen that infects 10-25% of antibiotic-associated diarrhea, accounting for 50-75% of antibiotic-associated enteritis and 90-100% of antibiotic-associated pseudomembranous. And there is growing evidence that Clostridium difficile infection is associated with other diseases such as active arthritis, sudden infant death, hemolytic uremia, necrotic enteritis, and Xishipronosis. Even worse, C. difficile has a recurrent infection and 15-20% of patients relapse after a successful cure. In recent years, with the emergence of virulent strains, the infection rate and incidence of Clostridium difficile increased year by year, the disease is more serious, the mortality caused by C. difficile infection also doubled. So far, the reason for the increased incidence of Clostridium difficile and its pathogenesis remains to be further studied. Because C. difficile is a spore-forming bacterium that is resistant to most antibiotics, the current treatment of metronidazole and vancomycin, the major antibacterials used in C. difficile control, is also declining, so to correctly understand the difficult shuttle Infection and epidemic of bacteria, to further understand its pathogenesis, to find new alternative therapies are imminent. In this paper, a comprehensive analysis of the causes of Clostridium difficile infection and epidemics was made, and its pathogenic mechanism was further summarized. The latest strategies and methods of Clostridium difficile control were also discussed, which will be helpful for better understanding and research Clostridium difficile, provide a new idea for the prevention and treatment of Clostridium difficile.