Clostridium difficile infection: current perspectives

被引:20
作者
Janka, Jacqueline [1 ]
O'Grady, Naomi R. [1 ]
机构
[1] NIH, Dept Crit Care Med, Bethesda, MD 20892 USA
关键词
Clostridium difficile; Clostridium difficile infection; colitis; diarrhea; North American pulse-field gel electrophoresis type 1; PCR ribotype 027; restriction endonuclease type BI; PROTON-PUMP INHIBITORS; MOLECULAR ANALYSIS; UNITED-STATES; DISEASE; DIARRHEA; VANCOMYCIN; RISK; STRAIN; METRONIDAZOLE; EPIDEMIOLOGY;
D O I
10.1097/MCC.0b013e328324e6ad
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
Purpose of review Clostridium difficile infection (CDI), long-associated with morbidity and mortality in healthcare settings, has evolved in recent years with unprecedented clinical manifestations. Today, CDI is characterized by unusually toxigenic and resistant subtypes, expanded epidemiology, and a growing list of risk factors. In this article, we discuss current trends and research for CDI in critical care settings, and new controversies that influence clinical practice. Recent findings CDI is the focus of intense and comprehensive research. For the critical care practitioner, relevant knowledge includes diagnosis of CDI, defining the severity of disease, the role of proton pump inhibitors, and treatment options for refractory or relapsing disease. Summary Annually, CDI adds billions of dollars to US healthcare costs compared with just a few years ago, and reflects a new and profound pattern of morbidity and mortality. As this disease changes, our knowledge and practice patterns must adjust to meet the current challenge of CDI.
引用
收藏
页码:149 / 153
页数:5
相关论文
共 35 条
  • [1] Recurrent Clostridium difficile colitis:: Case series involving 18 patients treated with donor stool administered via a nasogastric tube
    Aas, J
    Gessert, CE
    Bakken, JS
    [J]. CLINICAL INFECTIOUS DISEASES, 2003, 36 (05) : 580 - 585
  • [2] Treatment of Clostridium difficile-associated disease:: old therapies and new strategies
    Aslam, S
    Hamill, R
    Musher, DM
    [J]. LANCET INFECTIOUS DISEASES, 2005, 5 (09) : 549 - 557
  • [3] Antibiotic treatment for Clostridium difficile-associated diarrhea in adults
    Bricker, E
    Garg, R
    Nelson, R
    Loza, A
    Novak, T
    Hansen, J
    [J]. COCHRANE DATABASE OF SYSTEMATIC REVIEWS, 2005, (01):
  • [4] Association of proton-pump inhibitors with outcomes in Clostridium difficile colitis
    Cadle, Richard M.
    Mansouri, Mohammad D.
    Logan, Nancy
    Kudva, Denise R.
    Musher, Daniel A.
    [J]. AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, 2007, 64 (22) : 2359 - 2363
  • [5] Centers for Disease Control and Prevention (CDC), 2005, MMWR Morb Mortal Wkly Rep, V54, P1201
  • [6] Use of gastric acid-suppressive agents and the risk of community-acquired Clostridium difficile-associated disease
    Dial, S
    Delaney, JAC
    Barkun, AN
    Suissa, S
    [J]. JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2005, 294 (23): : 2989 - 2995
  • [7] Risk of Clostridium difficile diarrhea among hospital inpatients prescribed proton pump inhibitors:: cohort and case-control studies
    Dial, S
    Alrasadi, K
    Manoukian, C
    Huang, A
    Menzies, D
    [J]. CANADIAN MEDICAL ASSOCIATION JOURNAL, 2004, 171 (01) : 33 - 38
  • [8] Proton pump inhibitor use and risk of community-acquired Clostridium difficile-associated disease defined by prescription for oral vancomycin therapy
    Dial, Sandra
    Delaney, J. A. Chris
    Schneider, Verena
    Suissa, Samy
    [J]. CANADIAN MEDICAL ASSOCIATION JOURNAL, 2006, 175 (07) : 745 - 748
  • [9] Short- and long-term attributable costs of Clostridium difficile -: Associated disease in nonsurgical inpatients
    Dubberke, Erik R.
    Reske, Kimberly A.
    Olsen, Margaret A.
    McDonald, L. Clifford
    Fraser, Victoria J.
    [J]. CLINICAL INFECTIOUS DISEASES, 2008, 46 (04) : 497 - 504
  • [10] Severity of clostridium difficile associated disease (CDAD) in allogeneic stem cell transplant recipients: Evaluation of a CDAD severity grading system
    Dubberke, Erik R.
    Sadhu, Justin
    Gatti, Robert
    Reske, Kimberly A.
    DiPersio, John F.
    Devine, Steven M.
    Fraser, Victoria J.
    [J]. INFECTION CONTROL AND HOSPITAL EPIDEMIOLOGY, 2007, 28 (02) : 208 - 211