tailieunhanh - Báo cáo y học: "Bench-to-bedside review: Clostridium difficile colitis"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học Critical Care giúp cho các bạn có thêm kiến thức về ngành y học đề tài: Bench-to-bedside review: Clostridium difficile colitis. | Available online http content 12 1 203 Review Bench-to-bedside review Clostridium difficile colitis Carolyn V Gould and L Clifford McDonald Prevention and Response Branch Division of Healthcare Quality Promotion Centers for Disease Control and Prevention Clifton Road NE Atlanta GA 30333 USA Corresponding author L Clifford McDonald CMcDonald1@ Published 18 January 2008 This article is online at http content 12 1 203 2008 BioMed Central Ltd Critical Care 2008 12 203 doi cc6207 See related commentary by Pop-Vicas and Neill http content 12 1 114 Abstract In recent years the incidence and severity of Clostridium difficile-associated disease CDAD have increased dramatically. Beginning in 2000 widespread regional outbreaks associated with a previously uncommon hypervirulent strain of C. difficile have occurred in North America and Europe. Most likely because of increased toxin production as well as other virulence factors this epidemic strain has caused more severe and refractory disease leading to complications including intensive care unit admission colectomies and death. Worldwide increasing use of fluoroquinolones and cephalosporins has likely contributed to the proliferation of this epidemic strain which is highly resistant to both. The elderly have been disproportionately affected by CDAD but C. difficile has also recently emerged in populations previously considered to be at low risk including healthy outpatients and peripartum women although it is unknown if these cases are related to the epidemic strain. Nevertheless transmission within hospitals is the major source of C. difficile acquisition and previous or concurrent antimicrobial use is almost universal among cases. Applying current evidence-based strategies for management and prevention is critically important and clinicians should maintain an awareness of the changing epidemiology of CDAD and take measures to reduce the risk of disease in patients. .

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