艰难梭状芽胞杆菌毒素B测定在抗生素应用者中的调查

INVESTIGATION OF CLOSTRIDIUM DIFFICILE CYTOTOXIN B IN PATIENTS RECEIVED ANTIOTICS

用Hela细胞培养法调查224例用抗生素治疗及86例未用抗生素者粪中艰难梭状芽胞杆菌毒素B检出率、毒素效价及捡出率与抗生素种类的关系。结果表明多种抗生素组的检出率高于单一抗生素组,但毒素B的存在、效价与腹泻的关系,敏感性和特异性均不高,仅能配合临床资料作辅助诊断。

Hela cell culture was used for detection of Clostridium difficile cytotoxin in 354 stool specimens of 224 adult patients who received antibiotic therapy. Eighty-six specimens of adult patients not exposed to antibiotics were used as control. Cytotoxin was identified in 34.0% of 47 cases with diarrhea and 26.6% of 177 cases without diarrhea. In fact, cases with cytotoxin titer 1:200 were found more in non-diarrhea group. These results showed that there was no correlation between the presence of cytotoxin or and cytotoxin titer with diarrhea. Cytotoxin was recognized in 18.2% (12/66)cases treated with single antibiotic and in 32.3% (51/158) cases treated with multiple antibiotics, showingastatistical difference between the positive rate of them. Cytotoxin was also detectable in 8.1% (7/86) patients not exposed to antibiotics. The cytotoxin test in antibiotic induced diarrhea was non specific and non sensitive, a new, specific and sensitive test should be explored.