艰难梭菌感染与儿科炎症性肠病。
Clostridioides difficile Infection in Pediatric Inflammatory Bowel Disease.
机构信息
Division of Molecular Pathogenesis, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.
Immunology & Inflammation (VI4), Vanderbilt Institute for Infection, Vanderbilt University Medical Center, Nashville, TN, USA.
出版信息
Curr Gastroenterol Rep. 2023 Nov;25(11):316-322. doi: 10.1007/s11894-023-00890-9. Epub 2023 Aug 30.
PURPOSE OF REVIEW
Children with inflammatory bowel disease (IBD) are at increased risk of C. difficile infection (CDI) and experience worse outcomes associated with an infection. In this article, we review recent research on the incidence, diagnosis, complications, and treatment options for CDI in children with IBD.
RECENT FINDINGS
Children with IBD have an elevated incidence of CDI, but their CDI risk does not associate with established risk factors in adults with IBD. Existing testing methodologies are inadequate at differentiating CDI from C. difficile colonization in children with IBD. Fecal microbiota transplantation offers a durable cure for recurrent CDI. CDI remains a frequent occurrence in children with IBD. Careful clinical monitoring should be used to diagnose CDI and patients with co-occurring IBD and CDI require careful surveillance for worse outcomes. Future research should explore the optimal diagnosis and treatment modalities in this unique patient population.
目的综述
炎症性肠病（IBD）患儿发生艰难梭菌感染（CDI）的风险增加，且与感染相关的结局更差。本文综述了 IBD 患儿 CDI 的发病率、诊断、并发症和治疗选择的最新研究进展。
最近发现
IBD 患儿 CDI 的发病率较高，但他们的 CDI 风险与成人 IBD 中的既定危险因素无关。现有的检测方法在区分 IBD 患儿的 CDI 和艰难梭菌定植方面不够充分。粪便微生物群移植为复发性 CDI 提供了持久的治愈方法。CDI 在 IBD 患儿中仍频繁发生。应仔细进行临床监测以诊断 CDI，同时伴有 IBD 和 CDI 的患者需要仔细监测以预防更差的结局。未来的研究应探讨这一独特患者群体的最佳诊断和治疗方式。
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