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