艰难梭菌发病机理及防治。

IF 103.3 1区 生物学 Q1 MICROBIOLOGY
Caroline H Chilton, Virginie Viprey, Charmaine Normington, Ines B Moura, Anthony M Buckley, Jane Freeman, Kerrie Davies, Mark H Wilcox
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引用次数: 0

摘要

艰难梭菌感染(CDI)在患者死亡率和发病率以及与治疗、诊断和管理相关的经济成本方面仍然是世界范围内一个显著的负担。几十年来,艰难梭菌的流行病学发生了显著变化,严重急性呼吸综合征冠状病毒2大流行、抗生素耐药性和抗微生物药物使用造成的选择压力加剧了临床压力,导致CDI率居高不下。艰难梭菌的诊断和治疗具有挑战性,因为它会形成孢子,并可在肠道内无症状地持续存在。一些菌株表达多种毒力因子,包括粘附素和毒素。肠道微生物群在CDI中至关重要,因为健康的微生物群可以抵抗艰难梭菌的定植。通常由接触抗微生物药物引起的生态失调,使艰难梭菌孢子能够发芽并产生毒素,引起从轻度腹泻到暴发性结肠炎和死亡的各种症状。本文介绍了流行病学的变化和对诊断的影响,讨论了最近在理解发病机制和抗生素耐药性方面的突破,探讨了微生物群失调在CDI中的作用和新的微生物群治疗方法。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Clostridioides difficile pathogenesis and control.

Clostridioides difficile infection (CDI) continues to be a notable burden worldwide, both in terms of patient mortality and morbidity, and the economic costs associated with treatment, diagnosis and management. The epidemiology of C. difficile has changed markedly over the decades, with high CDI rates driven by clinical pressures exacerbated by the severe acute respiratory syndrome coronavirus 2 pandemic, antibiotic resistance and selective pressures caused by antimicrobial use. C. difficile is challenging to diagnose and treat as it forms spores and can persist asymptomatically within the gut. Some strains express multiple virulence factors, including adhesins and toxins. The gut microbiota is crucially important in CDI, as a healthy microbiota is resistant to colonization with C. difficile. Dysbiosis, often caused by antimicrobial exposure, enables C. difficile spores to germinate and produce toxin, causing symptoms that can range from mild diarrhoea to fulminant colitis and death. This Review describes changes in epidemiology and effects on diagnosis, discusses recent breakthroughs in the understanding of pathogenesis and antibiotic resistance and explores the role of microbiota dysbiosis in CDI and novel microbiota therapies in CDI treatment.

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来源期刊
Nature Reviews Microbiology
Nature Reviews Microbiology 生物-微生物学
CiteScore
74.00
自引率
0.50%
发文量
149
审稿时长
6-12 weeks
期刊介绍: At Nature Reviews Microbiology, our goal is to become the leading source of reviews and commentaries for the scientific community we cater to. We are dedicated to publishing articles that are not only authoritative but also easily accessible, supplementing them with clear and concise figures, tables, and other visual aids. Our objective is to offer an unparalleled service to authors, referees, and readers, and we continuously strive to maximize the usefulness and impact of each article we publish. With a focus on Reviews, Perspectives, and Comments spanning the entire field of microbiology, our wide scope ensures that the work we feature reaches the widest possible audience.
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