Clostridium difficile-associated diarrhea:: an emerging threat to pregnant women

被引：71

作者：

Rouphael, Nadine G. ^{[1
]}

O'Donnell, Judith A. ^{[5
]}

Bhatnagar, Julu ^{[2
]}

Lewis, Felicia ^{[3
,10
]}

Polgreen, Philip M. ^{[7
]}

Beekmann, Susan ^{[7
]}

Guarner, Jeannette ^{[8
]}

Killgore, George E. ^{[4
]}

Coffman, Becky ^{[9
]}

Campbell, Jennifer ^{[6
]}

Zaki, Sherif R. ^{[2
]}

McDonald, L. Clifford ^{[4
]}

机构：

[1] Ctr Dis Control & Prevent, Div Bacterial Dis, Atlanta, GA 30333 USA

[2] Ctr Dis Control & Prevent, Atlanta, GA USA

[3] Ctr Dis Control & Prevent, Epidem Intelligence Serv Field Assignments Branch, Off Workforce & Career Dev, Atlanta, GA USA

[4] Ctr Dis Control & Prevent, Div Healthcare Qual Promot, Atlanta, GA USA

[5] Drexel Univ, Coll Med, Div Infect Dis, Philadelphia, PA 19104 USA

[6] Drexel Univ, Coll Med, Dept Obstet & Gynecol, Philadelphia, PA 19104 USA

[7] Amer Emerging Infect Network, Infect Dis Soc, Iowa City, IA USA

[8] Emory Univ, Sch Med, Dept Pathol & Lab Med, Atlanta, GA 30322 USA

[9] Oklahoma Dept Hlth, Oklahoma City, OK USA

[10] Philadelphia Dept Publ Hlth, Philadelphia, PA USA

来源：

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY | 2008年 / 198卷 / 06期

关键词：

case series; Clostridium difficile; pregnancy; survey;

D O I：

10.1016/j.ajog.2008.01.062

中图分类号：

R71 [妇产科学];

学科分类号：

100211 ;

摘要：

OBJECTIVE: To estimate if Clostridium difficile-associated disease (CDAD) is increasing in peripartum women. STUDY DESIGN: Peripartum CDAD was assessed through 1) passive surveillance collecting clinical and pathology data on severe cases and 2) survey among infectious disease consultants (ICDs) in the Emerging Infections Network. RESULTS: Ten severe cases were collected; most had associated antibiotic use. Seven women were either admitted to the ICU or underwent colectomy. Three infants were stillborn, and 3 women died. The epidemic Clostridium difficile strain was found in 2 cases. Among 798 ICDs, 419 (52%) participated in the survey. Thirty-seven respondents (9%) recalled 55 cases, mostly in the postpartum period with 21 complications, mainly due to relapse. CONCLUSION: Severe CDAD may be increasing in peripartum women. Clinicians should have a low threshold for testing, be aware of the potential for severe outcomes, and take steps to reduce both the risk of disease and resultant complications.

引用

页码：635.e1 / 635.e6

页数：6

共 24 条

[1] PSEUDOMEMBRANOUS COLITIS FOLLOWING PROPHYLACTIC ANTIBIOTIC USE IN PRIMARY CESAREAN-SECTION [J].

ARSURA, EL ;

FAZIO, RA ;

WICKREMESINGHE, PC .

AMERICAN JOURNAL OF OBSTETRICS AND GYNECOLOGY, 1985, 151 (01) :87-89

[2] Treatment of Clostridium difficile-associated disease:: old therapies and new strategies [J].

Aslam, S ;

Hamill, R ;

Musher, DM .

LANCET INFECTIOUS DISEASES, 2005, 5 (09) :549-557

[3] Lack of association between the increased incidence of Clostridium difficile-associated disease and the increasing use of alcohol-based hand rubs [J].

Boyce, John M. ;

Ligi, Cathy ;

Kohan, Cindy ;

Dumigan, Diane ;

Havill, Nancy L. .

INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2006, 27 (05) :479-483

[4] Stress system activity, innate and T helper cytokines, and susceptibility to immune-related diseases [J].

Calcagni, Emanuele ;

Elenkov, Ilia .

BASIC AND CLINICAL ASPECTS OF NEUROENDOCRINE IMMUNOLOGY IN RHEUMATIC DISEASES, 2006, 1069 :62-76

[5]

Centers for Disease Control and Prevention (CDC), 2005, MMWR Morb Mortal Wkly Rep, V54, P1201

[6] Fulminant Clostridium difficile:: An underappreciated and increasing cause of death and complications [J].

Dallal, RM ;

Harbrecht, BG ;

Boujoukas, AJ ;

Sirio, CA ;

Farkas, LM ;

Lee, KK ;

Simmons, RL .

ANNALS OF SURGERY, 2002, 235 (03) :363-372

[7] Fulminant Postcesarean Clostridium difficile pseudomembranous colitis [J].

Ghai, Sonia ;

Ghai, Vikas ;

Sunderji, Shiraz .

OBSTETRICS AND GYNECOLOGY, 2007, 109 (02) :541-543

[8] Immunohistochemical evidence of Clostridium sp, Staphylococcus aureus, and group A Streptococcus in severe soft tissue infections related to injection drug use [J].

Guarner, Jeannette ;

Bartlett, Jeanine ;

Reagan, Sarah ;

Fischer, Marc ;

Finn, Stephen ;

O'Briain, D. Sean ;

Black, Marjorie ;

Hood, John ;

Zaki, Sherif R. .

HUMAN PATHOLOGY, 2006, 37 (11) :1482-1488

[9] Clostridium difficile infection in obstetric and gynecologic patients [J].

James, AH ;

Katz, VL ;

Dotters, DJ ;

Rogers, RG .

SOUTHERN MEDICAL JOURNAL, 1997, 90 (09) :889-892

[10] Asymptomatic carriage of Clostridium difficile and serum levels of IgG antibody against toxin A. [J].

Kyne, L ;

Warny, M ;

Qamar, A ;

Kelly, CP .

NEW ENGLAND JOURNAL OF MEDICINE, 2000, 342 (06) :390-397

← 1 2 3 →