Prevention and treatment of C. difficile in cancer patients.

IF 3.6 3区 医学 Q2 INFECTIOUS DISEASES
Current Opinion in Infectious Diseases Pub Date : 2023-12-01 Epub Date: 2023-07-31 DOI:10.1097/QCO.0000000000000954
Pedro Puerta-Alcalde, Carolina Garcia-Vidal, Alex Soriano
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引用次数: 2

Abstract

Purpose of review: We provide an update on the recent literature on Clostridioides difficile infection (CDI) in cancer patients.

Recent findings: Distinguishing between colonization and infection remains challenging in cancer patients. Many patients with negative toxin analysis are still treated for CDI, and some meet criteria for severe cases. The incidence of CDI is high in cancer patients, especially those with haematological malignancies. Disruption of the gut microbiome due to antibiotic consumption, chemotherapy and radiotherapy is the primary factor contributing to CDI development. The severity of CDI in cancer patients is often unclear due to the absence of well-defined severity criteria. Certain microbiome species predominance and specific ribotypes have been associated with worse outcomes. Whole genome sequencing could be helpful for differentiating recurrence from reinfection and exploring potential nosocomial transmission. While certain new drugs such as fidaxomicin or bezlotoxumab show promise, the optimal treatment and prevention strategies for CDI in cancer patients remain uncertain. Faecal microbiota transplantation (FMT) holds potential for reducing CDI recurrence rates.

Summary: Further studies are needed to provide robust recommendations for diagnosis, grading severity, and therapeutic management of CDI in cancer patients. Recurrences are particularly concerning due to subsequent exposition to CDI risk factors.

癌症患者难辨梭菌的防治。
综述目的:我们提供了癌症患者艰难梭菌感染(CDI)的最新文献。最近的发现:在癌症患者中,区分定植和感染仍然具有挑战性。许多毒素分析呈阴性的患者仍在接受CDI治疗,有些患者符合严重病例的标准。CDI在癌症患者中的发病率很高,尤其是那些血液系统恶性肿瘤患者。抗生素消耗、化疗和放疗对肠道微生物组的破坏是导致CDI发展的主要因素。癌症患者CDI的严重程度通常不清楚,因为缺乏明确的严重程度标准。某些微生物组物种的优势和特定的核糖类型与更糟糕的结果有关。全基因组测序可能有助于区分复发和再次感染,并探索潜在的医院传播。尽管某些新药,如菲达司明或贝佐单抗显示出前景,但癌症患者CDI的最佳治疗和预防策略仍不确定。粪便微生物群移植(FMT)具有降低CDI复发率的潜力。摘要:需要进一步的研究为癌症患者CDI的诊断、分级严重程度和治疗管理提供有力的建议。由于随后暴露于CDI风险因素,复发尤其令人担忧。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
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来源期刊
CiteScore
6.70
自引率
2.60%
发文量
121
审稿时长
6-12 weeks
期刊介绍: This reader-friendly, bimonthly resource provides a powerful, broad-based perspective on the most important advances from throughout the world literature. Featuring renowned guest editors and focusing exclusively on two topics, every issue of Current Opinion in Infectious Disease delivers unvarnished, expert assessments of developments from the previous year. Insightful editorials and on-the-mark invited reviews cover key subjects such as HIV infection and AIDS; skin and soft tissue infections; respiratory infections; paediatric and neonatal infections; gastrointestinal infections; tropical and travel-associated diseases; and antimicrobial agents.
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