成年人中Clostridium difficile的诊断和治疗:系统性审查
Natasha Bagdasarian1, Krishna Rao2, Preeti N Malani2
1Division of Infectious Disease, Department of Infection Control, St John Hospital and Medical Center, Detroit, Michigan2Department of Internal Medicine, Wayne State University, Detroit, Michigan.
困难菌感染 (CDI) 诊断需要有症状的患者. 旺科米辛在严重的CDI中是首选的,在轻微的病例中是甲尼达,而像菲达克索米辛和便微生物群移植这样的新疗法在复发性感染中显示出前景.
科学领域:
- 传染性疾病 传染性疾病
- 微生物学 微生物学
- 胃肠病学 胃肠病学
背景情况:
- 自2000年以来,Clostridium difficile感染 (CDI) 的发生率和严重程度显著增加.
- 有效的管理策略对于这种日益严重的公共卫生问题至关重要.
研究的目的:
- 对现有关于成年患者 (年龄≥18岁) CDI诊断和治疗最佳实践的证据进行全面审查.
- 为临床决策提供信息,并改善CDI患者的治疗结果.
主要方法:
- 在欧维德的MEDLINE和Cochrane数据库 (1978-2014) 中进行系统的文献搜索.
- 包括指南,系统审查和元分析,优先考虑临床试验和大型观察性研究.
- 从最初的4682篇文章中选择了116篇相关文章.
主要成果:
- 实验室检测无法区分殖民和感染;诊断方法很复杂.
- 多步或单步PCR测定表明CDI诊断的最佳性能特征.
- 建议在严重的CDI中使用万科米辛,而在轻度的CDI中使用甲尼达. 菲达克索米辛和便微生物群移植对复发性CDI有希望.
结论:
- CDI诊断测试应保留给有症状的个体.
- 治疗决策必须考虑疾病的严重程度,先前的CDI病史和复发风险.
- 范科米辛是重症/并发性CDI的首选药物;对于复发性或高风险病例,菲达克索米辛和便微生物群移植是可选的.
更多相关视频
12:58A Protocol to Characterize the Morphological Changes of Clostridium difficile in Response to Antibiotic Treatment
Published on: May 25, 2017
09:12A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
相关概念视频
Chronic Bowel Disorders: Introduction
Irritable Bowel Syndrome (IBS) is a common disorder affecting the gastrointestinal tract. The distinctive feature is recurrent abdominal pain associated with altered bowel movements, manifesting as constipation, diarrhea, or fluctuating between both. The...
Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
Drugs for Treatment of Ulcerative Colitis in IBD
Irritable Bowel Syndrome III: Medical and Nursing Management
Inflammatory Bowel Disease V: Surgical Management
Here are some common surgical interventions for IBD:
Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care
