[The diagnosis and treatment of Clostridium difficile enterocolitis]

Sixteen strains of Clostridium difficile (C.d) were isolated from 29 patients with antibiotic-associated diarrhoea (AAD). 9 of 14 C.d positive and 1 of 6 C.d negative fecal specimens were detected as cytotoxin positive. 10 AAC patients received colonoscopy and 6 had congestion, edema and erosion of mucosa. Three had yellow-white pseudomembrane on the surface of colon. In 17 Clostridium difficile enterocolitis (CDEC) was diagnosed by C.d isolation, cytotoxin detection and (or) colonoscopic finding. All the 17 patients received antibiotics before diarrhoea. The risk antibiotics were gentamycin, ampicillin and cephalosporin. Of 17 CDEC, 4 were cured when the complicated antibiotics were discontinued. 7 received vancomycin therapy. 6 cured but 1 had once symptomatic recurrence and C.d re-appearance. 4 were cured by metronidazole. 2 patients died of CDEC and respiratory failure prospectively before diagnosis. Eleven fecal specimens of CDEC were analysed for intestinal microflora. The results showed that E. coli and Bifidobacteria in CDEC patients were significantly lower.