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2002, Número 1

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Gac Med Mex 2002; 138 (1)


Infección por Clostridium difficile

Portillo-López MI, Castellanos-Urdaibay MA, Cortés-Nava E, Chiprut R

Idioma: Español
Referencias bibliográficas: 72
Paginas: 57-66
Archivo PDF: 93.63 Kb.


RESUMEN

El Clostridium difficile es un bacilo anaerobio formador de esporas subterminales grandes, de forma oval, localizadas en el intestino. Posee dos enterotoxinas que producen amplios daños en las células del intestino y así ocasionar diarrea. Los pacientes pueden presentar un amplio espectro de la enfermedad, que va de la diarrea simple no complicada asociada al uso de antibióticos, hasta la colitis seudomembranosa asociada al uso de éstos, potencialmente mortal. El C. difficile no tiene serotipos. Existen cepas patógenas y no patógenas. Las últimas producen cantidades variables de toxina A (enterotoxina) y B (citotoxina). Los tratamientos con antibióticos de amplio espectro eliminan gran cantidad de la flora normal, permitiendo sobrecrecimiento del C. difficile patógeno. No existen defensas inmunológicas definidas del huésped. El tratamiento puede basarse en metronidazol o vancomicina, aunque suelen ocurrir recidivas. Puede requerirse tratamiento de apoyo.


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