甘肃地区艰难梭菌感染情况及危险因素研究  

The Incidence and Risk Factors of Clostridium Difficile Infection in Gansu Province

作　　者：颉晓玲[1] 李洋 刘志武[2] 孙隆洁 Xie Xiaoling;Li Yang;Liu Zhiwu;Sun Longjie(Department of Central Laboratory,the First Hospital of Lanzhou University,Lanzhou 730000,China;Department of Laboratory Medicine,the First Hospital of Lanzhou University,Lanzhou 730000,China;School of Stomatology,Lanzhou University,Lanzhou 730000,China)

机构地区：[1]兰州大学第一医院中心实验室,甘肃兰州730000 [2]兰州大学第一医院检验科,甘肃兰州730000 [3]兰州大学口腔医学院,甘肃兰州730000

出　　处：《甘肃科学学报》2021年第4期60-63,共4页Journal of Gansu Sciences

基　　金：甘肃省卫生行业科研计划项目(GSWSKY2018-42)。

摘　　要：研究甘肃地区艰难梭菌感染(CDI)情况,对危险因素进行了分析,为临床CDI诊治与防控提供依据。收集兰州大学第一医院2019年7月—2020年1月腹泻患者粪便标本,进行厌氧培养及质谱鉴定获得菌株,核酸扩增检测艰难梭菌A、B毒素基因。根据CDI诊断标准分CDI组和非CDI组,收集患者资料进行统计分析。研究结果表明:艰难梭菌感染阳性率12.18%;单因素分析发现头孢类抗生素、使用2种及以上抗生素与CDI发生有关(P<0.05),实验室参数中血清总蛋白、白蛋白、总胆固醇、甘油三脂、高密度脂蛋白胆固醇,CDI组均低于非CDI组,且差距有统计学意义(P<0.05);多因素危险分析显示使用2种及以上抗生素是CDI的独立危险因素,实验室参数中高密度脂蛋白胆固醇降低与CDI相关。研究发现使用2种及以上抗生素是CDI独立危险因素,高密度脂蛋白胆固醇降低与CDI的发生相关。甘肃地区艰难梭菌感染发生率接近于国内其他地区研究结果,应当引起临床及感控部门注意。The purpose of this paper is to study the incidence and investigate the risk factors of Clostridium difficile infection(CDI)in Gansu province so as to provide evidence for the clinical diagnosis,treatment and prevention of CDI.The fecal specimens were collected from patients with diarrhea in the First Hospital of Lanzhou University from July 2019 to January 2020.The anaerobic culture and mass spectrometry were conducted for C.difficile strains,and the toxin genes A\,B of C.difficile were detected by nucleic acid amplification.CDI and non-CDI were grouped according to diagnostic criteria,then clinical information were collected respectively for statistical analysis.In total,the isolation rate of C.difficile was 12.18%.The result of the univariate analysis indicated that the incidence of CDI was associated with the cephalosporin and the use of two or more antibiotics(P<0.05).Among laboratory parameters,total serum protein,albumin,total cholesterol,triglyceride and high-density lipoprotein cholesterol of CDI were lower than non-CDI group(P<0.05).Multi-factor risk analysis shows that the use of two or more antibiotics is an independent risk factor for CDI,and the decrease of high-density lipoprotein cholesterol is related to the occurrence of CDI.The incidence of CDI in Gansu province should attract the attention of the clinical and infection control department.The use of antibiotics twice or more is an independent risk factor for CDI,and the decrease of HDL cholesterol is related to the occurrence of CDI.

关 键 词：艰难梭菌感染 危险因素 毒素基因检测 

分 类 号：R446.5[医药卫生—诊断学]