1例溃疡性结肠炎合并027型高产毒艰难梭菌感染的临床研究  

Clinical study of a case of ulcerative colitis combined with highly virulent Clostridium difficile infection of type 027

作　　者：曹慧玲[1] 赵苏瑛[1] 李岷[1] 陈秋霞[1] 朱小飞[1] CAO Huiling;ZHAO Suying;LI Min;CHEN Qiuxia;ZHU Xiaofei(Department of Clinical Laboratory,Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing,Jiangsu 210029,China)

机构地区：[1]南京中医药大学附属医院检验科,江苏南京210029

出　　处：《检验医学与临床》2024年第21期3243-3245,3250,共4页Laboratory Medicine and Clinic

基　　金：国家自然科学基金青年基金项目(81703830)。

摘　　要：目的分析溃疡性结肠炎合并027型高产毒艰难梭菌感染的临床特点和实验室检查结果。方法收集该院收治的1例溃疡性结肠炎患者的临床资料和实验室检查结果,并采用“艰难梭菌”和“溃疡性结肠炎”为关键词,对中国知网、Pubmed等数据库中2009年5月至2024年1月发表的文献进行检索。结果患者2023年出现不明原因腹痛、腹泻,确诊为溃疡性结肠炎,长期服用美沙拉嗪等抗炎药物,治疗期间病情反复发作,经实验室GeneXpert检测显示为艰难梭菌感染,并且为027型高产毒菌株,经抗感染治疗后好转。该研究共检索到文献673篇,排除653篇,最终保留相关文献20篇。结合病例分析和文献复习,该文主要从溃疡性结肠炎继发艰难梭菌感染的角度出发,重点叙述高产毒艰难梭菌的检测情况及方法,总结了艰难梭菌高产毒菌株对溃疡性结肠炎的影响等研究现状。结论艰难梭菌感染严重影响溃疡性结肠炎患者的病情进展和预后,特别是高产毒型菌株,该研究可为同种病例相关继发感染提供参考。同时,GeneXpert技术采用多重PCR原理,能快速检出艰难梭菌并筛选高产毒菌株,为临床的治疗及感染控制提供及时、准确的依据。Objective To analyze the clinical characteristics and laboratory test results of ulcerative colitis complicated with highly virulent Clostridium difficile infection of type 027.Methods Clinical data and laboratory tests were collected from a patient with ulcerative colitis admitted to the hospital.Additionally,a literature search was conducted using the keywords“Clostridium difficile”and“ulcerative colitis”in databases such as CNKI and PubMed for articles published from May 2009 to January 2024.Results The patient was diagnosed as ulcerative colitis with unexplained abdominal pain and diarrhea in 2023.The patient had been on long-term anti-inflammatory medication,including mesalazine,but experienced recurrent flare-ups during treatment.GeneXpert testing in the laboratory confirmed an infection with Clostridium difficile,specifically the highly virulent 027 strain.After receiving anti-infective treatment,the patient′s condition improved.A total of 673 articles were retrieved for this study,with 653 excluded,and finally 20 related literatures were retained.Combined with the literature review,this paper primarily discussed the secondary infection of Clostridium difficile in ulcerative colitis,with a focus on the detection methods and findings of highly virulent Clostridium difficile strains.The study also summarized the current research on the impact of highly virulent Clostridium difficile strains on ulcerative colitis.Conclusion Clostridium difficile infection significantly affects the progression and prognosis of patients with ulcerative colitis,especially in cases involving the highly virulent strains.This study provides a reference for similar cases involving secondary infections.Additionally,the GeneXpert technology,based on the principle of multiplex PCR,can rapidly detect Clostridium difficile and screen for highly virulent strains,offering timely and accurate support for clinical treatment and infection control.

关 键 词：溃疡性结肠炎 艰难梭菌感染 027型高产毒 GeneXpert 感染 

分 类 号：R446.5[医药卫生—诊断学] R574.62[医药卫生—临床医学]