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OEkosystem Darm Special - Updates on Clostridium difficile (Paperback, 1996 ed.)
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OEkosystem Darm Special - Updates on Clostridium difficile (Paperback, 1996 ed.)
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Jean-Claude Rambaud The place occupied today in basic and clinical
research by intestinal disease related to Clostridium difficile is
such that it is hard to remember that this range of disorders was
completely identified only in 1977-1978, even though pieces of the
puzzle had been identified much earlier. A brief historical review
of the discovery of the enteropathogenicity of C. difficile in man
might thus be useful. The bacterium was described in 1935 in the
stools of infants, using the name Bacillus difficilis [7]. Until
1977, the microorganism, renamed C. difficile, considered to be of
endogenous origin, was isolated only in rare cases of abscess or
infection, most often unrelated to the digestive tract. Its role in
genito-urinary infections [6] was not confirmed. However, the
frequency of infant healthy carriers was recognized from the outset
[7, 13]. Pseudo-membranous colitis (PMC) was described in 1883
following a gastroenterostomy. Many cases of this condition were
published subsequently before the antibiotic era, describing
various risk factors [4]. However the disease began to flourish
only with the increasingly wide use of antibiotics. Antibiotic
associated PMC was first described as an enterocolitis, though with
little pathological evidence. It was principally related to the use
of chloramphenicol and tetracyclines and attributed to
proliferation of Staphylococcus au reus [ 11], a concept
strengthened by the spectacular therapeutic action of vancomycin.
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