住院患者艰难梭菌无症状感染的危险因素分析  

Risk factors of asymptomatic carriers of Clostridium difficile among inpatients

作　　者：马开慧[1] 周妍妍[1] 吕治[1] MA Kaihui;ZHOU Yanyan;LYU Zhi(Clinical Laboratory Center,Beijing Friendship Hospital,Capital Medical University,Beijing 100053,China)

机构地区：[1]首都医科大学附属北京友谊医院临床检验中心,北京100053

出　　处：《国际检验医学杂志》2023年第3期331-335,共5页International Journal of Laboratory Medicine

摘　　要：目的分析住院患者无症状感染艰难梭菌的毒力特征及危险因素,为艰难梭菌感染(CDI)性腹泻的防治提供理论依据。方法收集住院患者的粪便标本。将其中的CDI患者分为CDI有腹泻组和CDI无腹泻组,将无腹泻症状且艰难梭菌培养阴性患者设为对照组。收集患者临床资料,将粪便标本进行艰难梭菌分离培养并进行艰难梭菌毒素检测,对临床资料及检测结果进行统计学分析。结果CDI有腹泻组毒素蛋白阳性率高于CDI无腹泻组(P<0.05)。多因素Logistic回归分析显示:使用抑酸剂、2个月内使用头孢菌素类抗菌药物、住院时间>2周是艰难梭菌无症状感染的独立危险因素(P<0.05)。结论艰难梭菌产毒素量是导致临床是否出现腹泻症状的重要因素;住院时间>2周、使用抑酸剂、2个月内使用头孢菌素类抗菌药物均是艰难梭菌无症状感染的独立危险因素。Objective To analyze the virulence characteristics and risk factors of Clostridium difficile(C.difficile)in asymptomatic carriage of inpatients,and provide theoretical basis for the prevention and treatment of C.difficile infection(CDI)diarrhea.Methods The fecal samples of inpatients were collected.The CDI patients were divided into diarrhea CDI group and non-diarrhea CDI group.The patients without neither diarrhea nor CDI were set as the control group.The clinical data of patients were collected,and the stool samples were isolated and cultured for C.difficile and tested for C.difficile toxin.The clinical data and test results were statistically analyzed.Results The expression of toxin proteins in the diarrhea CDI group was significantly higher than that in the non-diarrhea CDI group(P<0.05).Multivariate Logistic regression analysis showed the use of acid inhibitors,the use of cephalosporins within 2 months,and the length of hospital stay>2 weeks were independent risk factors for asymptomatic ICD(P<0.05).Conclusion The amount of toxin produced by Clostridium difficile is an important factor leading to clinical diarrhea;hospitalization time>2 weeks,the use of acid inhibitors and cephalosporins within 2 months are independent risk factors for asymptomatic infection of C.difficile.

关 键 词：艰难梭菌 无症状感染 危险因素 

分 类 号：R446.5[医药卫生—诊断学]