Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi

Yıl: 2013 Cilt: 47 Sayı: 3 Sayfa Aralığı: 556 - 566 Metin Dili: Türkçe İndeks Tarihi: 29-07-2022

Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi

Öz:
Clostridium difficile gram-pozitif, spor oluşturan anaerobik bir bakteridir. C.difficile antibiyotik ile ilişki- li ishal ve kolitlerin en önemli nedenidir. C.difficile enfeksiyonu (CDE) klinik spektrumu, hafif ishalden tok- sik megakolon, ileus, bağırsak perforasyonu ve psödomembranöz koliti içeren şiddetli intestinal hastalık tablosuna kadar oldukça değişken seyretmektedir. İleri yaş, hastanede kalış süresi ve özgün antibiyotikle- re maruz kalma CDE için en yaygın risk faktörleridir. C.difficile’nin temel virülans determinantları toksin A (enterotoksin) ve toksin B (sitotoksin) olup, CDE tanısı dışkı örneklerinde C.difficile toksin A ve/veya tok- sin B’nin tespit edilmesine dayanmaktadır. C.difficile ve toksinleri tespit etmek için günümüzde çeşitli la- boratuvar testleri geliştirilmiştir. Hücre kültürü sitotoksisite ve toksijenik kültür yöntemleri C.difficile tok- sinlerinin tespitinde referans yöntem olarak kabul edilmektedir. Ancak her iki yöntem de uygulanması güç, zaman alıcı ve uzman personel gerektiren yöntemlerdir. Bu nedenle çoğu mikrobiyoloji laboratuva- rında daha pratik ve hızlı olan enzim temelli immünolojik yöntemler, glutamat dehidrojenaz antijen test- leri ve gerçek zamanlı polimeraz zincir reaksiyonu (PCR) kullanılmaktadır. CDE tedavisinde ilk seçilecek antibiyotikler metronidazol ve vankomisindir. Bu derleme yazıda, CDE epidemiyolojisi, klinik özellikleri, risk faktörleri, patojenitesi, tanı testleri ve tedavisi özetlenmiştir.
Anahtar Kelime:

Konular: Mikrobiyoloji

Clostridium difficile infection: Epidemiology, risk factors, pathogenesis, clinical features, diagnosis and therapy

Öz:
Clostridium difficile is a gram-positive, spore-forming anaerobic bacterium. C.difficile is the leading cause of antibiotic associated diarrhea and colitis. The clinical spectrum of C.difficile infection (CDI) is highly variable, ranging from mild diarrhea to severe forms of intestinal illness including toxic megacolon, ileus, bowel perforation, and pseudomembranous colitis. Advanced age, long duration of hospitalization, and exposure to certain antimicrobial agents are the most common risk factors for CDI. The main virulence determinants of C.difficile are toxin A (enterotoxin) and toxin B (cytotoxin). Diagnosis of CDI is based on the identification of C.difficile toxin A or B in diarrheal stool. Various laboratory tests have been currently developed for the detection of C.difficile or its toxins in stool samples. The cell culture cytotoxicity assay and toxigenic culture have been regarded as the reference standard methods for the detection of C.difficile toxins. However, both of the reference methods are laborious, time consuming, and need expert personnel. Therefore, many microbiology laboratories use enzyme immunoassays, glutamate dehydrogenase antigen tests and real-time polymerase chain reaction (PCR) which are more rapid and practical. First-line antibiotics for CDI treatment are metronidazole and vancomycin. In this review, epidemiology, clinical spectrum, risk factors, pathogenesis, diagnostic methods and treatment of CDI have been summarized.
Anahtar Kelime:

Konular: Mikrobiyoloji
Belge Türü: Makale Makale Türü: Derleme Erişim Türü: Bibliyografik
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APA Kiliç A (2013). Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. , 556 - 566.
Chicago Kiliç Abdullah Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. (2013): 556 - 566.
MLA Kiliç Abdullah Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. , 2013, ss.556 - 566.
AMA Kiliç A Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. . 2013; 556 - 566.
Vancouver Kiliç A Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. . 2013; 556 - 566.
IEEE Kiliç A "Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi." , ss.556 - 566, 2013.
ISNAD Kiliç, Abdullah. "Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi". (2013), 556-566.
APA Kiliç A (2013). Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. Mikrobiyoloji Bülteni, 47(3), 556 - 566.
Chicago Kiliç Abdullah Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. Mikrobiyoloji Bülteni 47, no.3 (2013): 556 - 566.
MLA Kiliç Abdullah Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. Mikrobiyoloji Bülteni, vol.47, no.3, 2013, ss.556 - 566.
AMA Kiliç A Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. Mikrobiyoloji Bülteni. 2013; 47(3): 556 - 566.
Vancouver Kiliç A Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi. Mikrobiyoloji Bülteni. 2013; 47(3): 556 - 566.
IEEE Kiliç A "Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi." Mikrobiyoloji Bülteni, 47, ss.556 - 566, 2013.
ISNAD Kiliç, Abdullah. "Clostridium difficile enfeksiyonu: Epidemiyoloji, risk faktörleri, patogenez, klinik özellikler, tanı ve tedavi". Mikrobiyoloji Bülteni 47/3 (2013), 556-566.