检索历史 清除

艰难梭菌（clostridium difficile,CD）是一种肠道条件致病菌，是抗生素相关性腹泻的主要病原体。近年来，儿童艰难梭菌感染（clostridium difficile infection,CDI）的发病率不断增加。最新数据显示，儿童CDI病例更多发生在医院以外，主要与社区感染相关。依靠传统的检测技术很可能会造成儿童CDI的过度诊断及治疗，新的检测技术如挥发性有机化合物、促炎细胞因子和粪便代谢物的测定有望提高儿童CDI的诊断水平。儿童CDI一线治疗推荐甲硝唑和万古霉素，对于多次复发的儿童CDI，粪菌移植术有很好的治疗前景，但其长期安全性仍然未知，尚需进一步研究。该文对近年来儿童CDI的研究进展尤其是在流行病学、诊断和治疗等方面作一综述。

Clostridium difficile（CD）is a pathogen of intestinal conditions and a major cause of antibiotic-associated diarrhea. In recent years，the incidence of clostridium difficile infection（CDI）in children has been increasing. The latest data show that more cases of CDI in children occur outside the hospital and are mainly associated with the community. Relying on traditional detection techniques is likely to lead to the over-diagnosis and treatment of CDI in children. New detection techniques such as volatile organic compounds，pro-inflammatory cytokines and fecal metabolites are expected to improve the diagnosis of CDI in children. Metronidazole and vancomycin are recommended as the first-line treatment of CDI in children. For children with recurrent CDI，fecal microbiota transplantation is promising，but its long-term safety is still unknown and further studies are needed. This article reviews the advances in CDI in children，especially in epidemiology，diagnosis and treatment.