摘要
近二十年来,抗生素的过度使用,促使高毒性和耐抗菌素的难辨梭状芽胞杆菌菌株流行,艰难梭菌感染(CDI)成为一种常见的卫生保健和抗生素相关的腹泻疾病,引起巨大临床和经济负担。目前,国内尚缺乏高度可操作的CDI专家共识或指南。2024年,来自中华医学会外科学分会、中国研究型医院学会感染性疾病循证与转化专业委员会的急重症、感染、外科专家就中国CDI诊断、治疗、预防的20个问题进行了系统性阐释,形成了《中国艰难梭菌感染诊治及预防指南(2024版)》。该指南更新了针对任何人群中诊断、治疗、防控CDI的随机对照试验(RCT)的系统综述,是国内第一部关于融合CDI诊治、感染控制的实践指南,将有利于临床医师形成诊、治、防的集束化思维和方法。为了该指南被急诊、检验、重症、院感等医疗部门尽快接受,本文就指南中CDI的诊断、治疗、防控,结合新的CDI临床诊治循证医学证据,做以下解读。
In the past two decades,the overuse of antibiotics has led to the prevalence of high-toxin and antibiotic-resistant clostridium difficile(C.difficile,CD)strains,and clostridium difficile infection(CDI)has become a common healthcare and antibiotic-related diarrhea disease,causing a huge clinical and economic burden.At present,there is a lack of highly operable expert consensus/guidelines for CDI in China.In 2024,experts in emergency,infection,and surgery from the Surgical Branch of the Chinese Medical Association and the Evidence-Based and Transformation Professional Committee of the Chinese Research Hospital Association systematically explained 20 issues related to the diagnosis,treatment,and prevention of clostridium difficile infection in China,forming the"Guidelines for diagnosis,treatment,and prevention of clostridium difficile infection in China(2024)".This guideline updates the systematic review of randomized controlled trials(RCTs)on the diagnosis,treatment,and prevention of CDI in any population,and is the first practice guideline on the diagnosis,treatment,and infection control of CDI in China,which will greatly help clinicians to form a cluster thinking and method of diagnosis,treatment,and prevention.In order for the guideline to be accepted by emergency,examination,intensive care,hospital infection and other medical departments as soon as possible,this article makes the following interpretation on the diagnosis,treatment and prevention and control of CDI in the guideline,combined with the new clinical diagnosis and treatment evidence of CDI.
作者
章晓红
王旸
王瑞钰
郑薇
王建
李洋
朱光亚
付晶
陈锋
李俊英
苏明华
王一凡
ZHANG Xiaohong;WANG Yang;WANG Ruiyu;ZHENG Wei;WANG Jian;LI Yang;ZHU Guangya;FU Jing;CHEN Feng;LI Junying;SU Minghua;WANG Yifang(Sichuan Provincial People's Hospital,Affiliated Hospital of University of Electronic Science and Technology of China,Chengdu 610072,China;Chengdu University of Traditional Chinese Medicine,Chengdu 611137,China)
出处
《西部医学》
2025年第8期1097-1102,共6页
Medical Journal of West China
基金
四川省中医药管理局科研项目(2024MS023)。
关键词
艰难梭菌
感染
炎性腹泻
抗生素
专家指南
Clostridium difficile
Infection
Infectious diarrhea
Antibiotic
Expert consensus
