宁夏地区临床腹泻患者艰难梭菌感染及危险因素  

Analysis of Clostridium difficile infection and risk factors in patients with clinical diarrhea in Ningxia region

作　　者：刘俊枫 李刚 臧一铭 马红 王文 贾伟 LIU Jun-feng;LI Gang;ZANG Yi-ming;MA Hong;WANG Wen;JIA Wei(Lanzhou University Second Hospital,Lanzhou,Gansu 730030,China;不详)

机构地区：[1]兰州大学第二医院检验医学中心,甘肃兰州730030 [2]宁夏医科大学临床医学院,宁夏银川750001 [3]宁夏医科大学总医院医学实验中心,宁夏银川750004 [4]宁夏病原微生物重点实验室,宁夏银川750004

出　　处：《中华医院感染学杂志》2022年第24期3687-3691,共5页Chinese Journal of Nosocomiology

基　　金：国家自然科学基金资助项目(81960386);宁夏自然科学基金优秀青年项目(2021AAC05020)。

摘　　要：目的了解宁夏医科大学总医院住院腹泻患者艰难梭菌感染(CDI)状况,并进行危险因素分析。方法收集宁夏医科大学总医院2019年1月1日-2020年12月1日530份腹泻粪便标本,进行厌氧培养、普通聚合酶链式反应(PCR)法检测毒素基因,采用1∶2病例对照研究(CDI组36例∶非CDI组72例)临床病历资料,分析CDI危险因素。结果530份粪便中检出艰难梭菌(CD)38株(检出率7.2%,38/530),产毒型CD 36株(感染率6.8%,36/530),以tcdA+tcdB+为主(29株,80.6%),多因素二元Logistic回归分析显示:CDI独立危险因素为有六个月内住院史(OR=5.612,95%CI 1.520~20.720,P=0.010)、患有胃肠道疾病(OR=4.240,95%CI 1.189~15.123,P=0.026)和患有肝胆疾病(OR=6.253,95%CI 1.671~23.405,P=0.006)。结论为预防CDI,建议临床对具有六个月内住院经历、罹患消化道疾病、肝胆疾病独立危险因素患者进行早期识别,以预防艰难梭菌在医院感染及流行。OBJECTIVE To understand the status of Clostridium difficile infection(CDI)in inpatients with diarrhea in the General Hospital of Ningxia Medical University,and analyze the risk factors for the infection.METHODS A total of 530 stool samples from patients with diarrhea in General Hospital of Ningxia Medical University from Jan.1,2019 to Dec.1,2020 were collected and used for anaerobic culture and polymerase chain reaction(PCR)to detect toxin genes.The clinical medical records were compared by 1∶2 case-control studies(36 cases in the CDI group and 72 cases in non-CDI group)and the risk factors for CDI were analyzed.RESULTS Thirty-eight strains of Clostridium difficile(CD)were detected in 530 stool samples(detection rate of 7.2%,38/530),and 36 strains were toxin-producing CD strains(infection rate of 6.8%,36/530),mainly tcdA+tcdB+(29 strains,80.6%).Multivariate binary logistic regression analysis showed that the independent risk factor for CDI was hospitalization within six months(OR=5.612,95%CI 1.520-20.720,P=0.010),gastrointestinal disease(OR=4.240,95%CI 1.189-15.123,P=0.026)and hepatobiliary disease(OR=6.253,95%CI 1.671-23.405,P=0.006).CONCLUSION In order to prevent CDI,it is recommended that patients with independent risk factors of digestive tract disease and liver and gallbladder disease with hospitalization experience within six months should be clinically identified early,in order to prevent the infection and epidemic of Clostridium difficile in the hospital.

关 键 词：艰难梭菌 感染 腹泻 毒素基因 危险因素 

分 类 号：R378[医药卫生—病原生物学]