Relationship between Clostridium difficile associated diarrhea and intestinal microecosystem disorder in patients received allogeneic hematopoietic stem cell transplantation.
- Author:
Jin-Song JIA
1
;
Xiao-Jun HUANG
;
Dai-Hong LIU
;
Lan-Ping XIU
;
Yao-Cen ZHANG
;
Tong WU
;
Jing-Bo WANG
;
Hong SU
;
Qi-Yan LU
;
Dao-Pei LU
Author Information
1. Department of Hematolgy, Beijing University People Hospital, Beijing University Institute of Hematolgy, Beijing 100044, China.
- Publication Type:Journal Article
- MeSH:
Adolescent;
Adult;
Anti-Bacterial Agents;
adverse effects;
therapeutic use;
Child;
Clostridium Infections;
microbiology;
Clostridium difficile;
growth & development;
Diarrhea;
microbiology;
Female;
Hematologic Neoplasms;
therapy;
Hematopoietic Stem Cell Transplantation;
adverse effects;
Humans;
Male;
Middle Aged;
Young Adult
- From:
Journal of Experimental Hematology
2008;16(1):135-139
- CountryChina
- Language:Chinese
-
Abstract:
This study was to investigate the relationship between Clostridium difficile associated diarrhea (CDAD) and intestinal microecosystem in patients received allogeneic hematopoietic stem cell transplantation (allo-HSCT) and to clarify clinical characteristics of intestinal microecosystem disorder. Clostridium difficile (CD) was isolated and identified by enzyme-linked-immunosorbent assay using clostridium difficile Premier toxins A&B Kit and anaerobic culture in 44 cases with diarrhea. Fecal flora (bifidobacteria, lactobacillus, bacteroides, peptostreptococcus, Clostridium perfringens, enterobacteriaceae, enterococcus, and yeasts) of patients were quantitatively and qualitatively analyzed by Mitsuoka's methods. The results showed that CDAD occurred after using antibiotic or chemotherapy. Clostridium difficile was detected in 12 patients with diarrhea (positive rate was 27.27%). There was marked changes of intestinal microecosystem when patients suffered from CDAD. The number of lactobacillus, bifidobacteria, bacteroides, enterobacteriaceae and so on decreased significantly. It was effective to treat CDAD with vancomycin, metronidazole and probiotic, but the recurrence rate was 16.67%. In conclusion, CDAD complicated by allo-HSCT is related to change of intestinal microecosystem. While treating CDAD with the sensitive antibiotic, the intestinal flora of patients should be supported actively. This treatment contributes to improving disease status and reducing diarrhea recurrence.
