肾内科3例艰难梭菌疑似医院感染暴发临床分析

Suspected nosocomial outbreak of 3 cases of Clostridium difficile infection in department of nephrology:a clinical analysis

目的:分析本院肾内科艰难梭菌疑似医院感染暴发的原因及预防措施。方法:回顾性分析2018年11月13日至29日本院肾内科发生的3例艰难梭菌感染患者的临床资料。结果:3例患者均为高龄女性(年龄76~82岁),均伴有基础性疾病、腹泻和C反应蛋白升高。3例患者粪便样本均检出产毒型艰难梭菌,tcdB基因阳性。采取规范的消毒隔离、提高手卫生依从性等系列措施,2018年12月至2019年2月肾内科未见艰难梭菌感染病例。结论:艰难梭菌感染暴发可能与患者本身原因及临床科室认识不足有关,针对出现疑似症状的高危患者可根据其临床特征,快速检测,早发现,早诊断,早干预,以减少院内感染播散。

Objective:To determine the causes and preventive measures of suspected nosocomial outbreak of Clostridium difficileinfection(CDI)in the Department of Nephrology of our hospital.Methods:The clinical data of three patients with CDI admitted to the Department of Nephrology in our hospital between November 13 and29,2018 were retrospectively analyzed.Results:All the three patients were elderly females(aged 76-82 years old)with underlying diseases,diarrhea,and elevated C-reactive protein(CRP).The toxigenicClostridium difficile(CD)and positive toxin B gene(tcdB)were detected in stool samples of all three patients.Through a series of measures were used,such as standardized disinfection/isolation and improvement of hand hygiene compliance,no case of CDI was found in the Department of Nephrology between December 2018 and February2019.Conclusion:The outbreak of CDI may be related to the patients’own causes and clinicians’insufficient understanding of CD.For high-risk patients with suspected symptoms,the rapid detection,early detection,early diagnosis,and early intervention may reduce the spread of nosocomial infection based on their clinical characteristics.