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首页> 外文期刊>Frontiers in Medicine >Global and Historical Distribution of Clostridioides difficile in the Human Diet (1981–2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Toward the Tropic
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Global and Historical Distribution of Clostridioides difficile in the Human Diet (1981–2019): Systematic Review and Meta-Analysis of 21886 Samples Reveal Sources of Heterogeneity, High-Risk Foods, and Unexpected Higher Prevalence Toward the Tropic

机译：在人饮食中的梭菌梭菌艰难梭菌的全球和历史分布（1981-2019）：系统评价和21886个样品的荟萃分析揭示了异质性，高风险食品的来源，并对热带的意外更高的流行

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Clostridioides difficile (CD) is a spore-forming bacterium that causes life-threatening intestinal infections in humans. Although formerly regarded as exclusively nosocomial, there is increasing genomic evidence that person-to-person transmission accounts for only 72%) employed the same (one-of-six) culture strategy. Because the prevalence was also meta-analytically similar across six culture strategies reported, all studies were integrated using three meta-analytical methods. At the study level ( n = 79), the four-decade global cumulative-prevalence of CD in the human diet was 4.1% (95%CI = ?3.71, 11.91). At the food-set level ( n = 232, mean 12.9 g/sample, similar across regions p 0.2; 95%CI = 9.7–16.2), the weighted prevalence ranged between 4.5% (95%CI = 3–6%; all studies) and 8% (95%CI = 7–8%; only CD-positive-studies). Risk-ratio ranking and meta-regression showed that milk was the least likely source of CD, while seafood, leafy green vegetables, pork, and poultry carried higher risks ( p 0.05). Across regions, the risk of CD in foods for foodborne exposure reproducibly decreased with Earth latitude ( p 0.001). In conclusion, CD in the human diet is a global non-random-source of foodborne exposure that occurs independently of laboratory culture methods, across regions, and at a variable level depending on food type and latitude. The latitudinal trend (high CD-food-prevalence toward tropic) is unexpectedly inverse to the epidemiological observations of CD-infections in humans (frequent in temperate regions). Findings suggest the plausible hypothesis that ecologically-richer microbiomes in the tropic might protect against intestinal CD colonization/infections despite CD ingestion.
机译：梭菌氧化钛酸纤维纤维素（CD）是一种孢子形成细菌，导致人类危及生命的肠道感染。虽然以前被视为专业的医院，但增加了基因组证据，即人对人的传播只有72％的人雇用相同（六个）文化策略。由于患有六种培养策略的患病率也是相似的，因此所有研究均采用三种荟萃分析方法整合。在研究水平（n = 79）中，人类饮食中的四十年全球累积患病率为4.1％（95％CI = 3.71,11.91）。在食物设定水平（n = 232，平均12.9g /样品，横跨区域P＆ 0.2; 95％CI = 9.7-16.2），加权流行率范围为4.5％（95％CI = 3-6％ ;所有研究）和8％（95％CI = 7-8％;只有CD阳性研究）。风险比率排名和元回归显示牛奶是CD的最不可能的来源，而海鲜，叶绿蔬菜，猪肉和家禽患有较高的风险（P <0.05）。跨越地区，食物中的食物中CD的风险与地球纬度可重复地降低（P <0.001）。总之，人类饮食中的CD是食物载暴露的全球非随机源，其在地区的实验室培养方法以及根据食物类型和纬度的可变水平发生。纬度趋势（热带热带的高CD-Feed-Pervalience）意外地与人类CD-感染的流行病学观察（频繁在温带地区）的流行病学观察结果相反。结果表明，尽管CD摄取，但热带生态较丰富的微生物体可能会保护肠CD结肠化/感染。

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