Clostridium difficile infection in the postcolectomy patient.

作者: Darren N. Seril , Bo Shen

DOI: 10.1097/MIB.0000000000000164

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摘要: Clostridium difficile infection (CDI) after total colectomy has been increasingly recognized over the past decade. C. enteritis (CDE) is a rare occurrence, whereas pouchitis (CDP) reported in approximately 10% of symptomatic patients seen at referral center for pouch dysfunction. Similar to colonic CDI general population, antibiotic use and comorbid diseases may be risk factors CDE. In contrast, postoperative antibiotics does not seem associated with CDP, male gender, recent hospitalization, presurgery were shown CDP. capable colonizing all intestinal sites, including ileal pouch. Similarities colon physiological cellular levels contribute susceptibility CDI. Postcolectomy likely represents disease spectrum from asymptomatic colonization severe infection. should considered ostomy fever increased ileostomy output change "normal" symptom pattern or chronic antibiotic-refractory pouchitis. Sensitive specific methods detection are available, endoscopy useful evaluating patient suspected CDE although pseudomembranes typically absent. Vancomycin used as first-line therapy CDP warranted inflammatory bowel Fecal microbiota transplantation found its management refractory but this approach requires evaluation

参考文章(158)
Y. -H. Ho, F. A. Yafi, C. R. Selvasekar, R. R. Cima, A. Habr-Gama, J. Gama-Rodrigues, R. O. Perez, I. Proscurshim, G. P. São Julião, D. Kruglensky, D. Kiss, I. Ceconello, C. A. Buchpiguel, M. Valero, D. Parés, M. Pera, L. Grande, Salvaging a linear staple line defect in ultra-low anterior resection Techniques in Coloproctology. ,vol. 12, pp. 73- ,(2008) , 10.1007/S10151-008-0402-1
M. Wayne Causey, Michael P. Spencer, Scott R. Steele, Clostridium difficile enteritis after colectomy. American Surgeon. ,vol. 75, pp. 1203- 1206 ,(2009) , 10.1177/000313480907501211
S. D. McLaughlin, S. K. Clark, C. H. Roberts, Z. L. Perry-Woodford, P. P. Tekkis, P. J. Ciclitira, R. J. Nicholls, Extended spectrum beta-lactamase-producing bacteria and Clostridium difficile in patients with pouchitis. Alimentary Pharmacology & Therapeutics. ,vol. 32, pp. 664- 669 ,(2010) , 10.1111/J.1365-2036.2010.04401.X
Ciaran P. Kelly, Charalabos Pothoulakis, Jose Orellana, J.Thomas Lamont, Human colonic aspirates containing immunoglobulin A antibody to Clostridium difficile toxin A inhibit toxin A-receptor binding. Gastroenterology. ,vol. 102, pp. 35- 40 ,(1992) , 10.1016/0016-5085(92)91781-X
D. DRUDY, C. O'FARRELLY, A. BAIRD, L. FENELON, D.P. O'DONOGHUE, Flow cytometric analysis of Clostridium difficile adherence to human intestinal epithelial cells Journal of Medical Microbiology. ,vol. 50, pp. 526- 534 ,(2001) , 10.1099/0022-1317-50-6-526
C Lavallée, B Laufer, J Pépin, A Mitchell, S Dubé, A-C Labbé, None, Fatal Clostridium difficile enteritis caused by the BI/NAP1/027 strain: a case series of ileal C. difficile infections Clinical Microbiology and Infection. ,vol. 15, pp. 1093- 1099 ,(2009) , 10.1111/J.1469-0691.2009.03004.X
J R Shortland, R C Spencer, J L Williams, Pseudomembranous colitis associated with changes in an ileal conduit. Journal of Clinical Pathology. ,vol. 36, pp. 1184- 1187 ,(1983) , 10.1136/JCP.36.10.1184
N A Shepherd, C J Healey, B F Warren, P I Richman, W H Thomson, S P Wilkinson, Distribution of mucosal pathology and an assessment of colonic phenotypic change in the pelvic ileal reservoir. Gut. ,vol. 34, pp. 101- 105 ,(1993) , 10.1136/GUT.34.1.101
Valéry Lavergne, Yannick Beauséjour, Gilbert Pichette, Marc Ghannoum, Shih Hann Su, Lymphopenia as a novel marker of Clostridium difficile infection recurrence Journal of Infection. ,vol. 66, pp. 129- 135 ,(2013) , 10.1016/J.JINF.2012.11.001