Pseudomembranous colitis: an update.

摘要: Clostridium difficile is the most common nosocomial infection of gastrointestinal tract. Most cases are associated with antibiotic therapy that alters fecal flora, allowing overgrowth C production its toxins. Diagnosis made by detection organism or toxin in stools. A variety different tests can be used, but none perfect. stool culture positive someone without diarrhea, ie, a carrier. While cytotoxin gold standard, it expensive, and there delay before results available. Thus, many laboratories use enzyme-linked immunoassay to detect because they more rapid screen. Depending on specific test A, B occasionally both. Sensitivity specificity rates vary. First line for disease should metronidazole 250 mg qid 10 days. Vancomycin reserved severe where has failed cannot tolerated contraindicated. Recurrent particularly vexing clinical problem. biotherapeutic approaches have been used. Retreatment antibiotics almost always necessary. In addition, nonpathogenic yeast Saccharomyces boulardii showed benefit as an adjunct preventing further recurrences.