ICU艰难梭菌感染及其影响因素分析

Influencing factors for Clostridium difficile infection in ICU

目的了解医院ICU腹泻患者艰难梭菌感染(Clostridium difficile infection,CDI)的发病率及其影响因素,为临床诊治提供一定参考价值。方法联合梅里埃miniVIDAS酶联荧光法和Gene Xpert C.difficile实时荧光PCR法的新鲜便标本检测结果,诊断CDI,回顾性收集患者临床资料并分析其影响因素。结果 ICU住院腹泻患者CDI的发病率为16.9%(10/59)。血钾浓度、促胃肠动力药物和万古霉素与CDI有关(P<0.05)。Logistic回归分析显示,促胃肠蠕动药物是CDI的独立影响因素;万古霉素是CDI的独立预防因素。结论可考虑将CDI检测作为ICU患者的常规检查;促胃肠蠕动药物是否会引起CDI仍需进一步研究。

OBJECTIVE To investigate the incidence and influencing factors for Clostridium difficile infection in diarrhea patients of ICU so as to provide guidance for clinical diagnosis and treatment. METHODS The fresh stool specimens were detected to diagnose the C.difficile infection by means of Merieux miniVIDAS enzyme linked fluorescent assay combined with Gene Xpert~?C.difficile real-time fluorescent PCR. The clinical data were retrospectively collected from the patients, and the influencing factors were analyzed. RESULTS The incidence of C.difficile infection was 16.9%(10/59) among the hospitalized patients of ICU. The C.difficile infection was associated with concentration of serum potassium, gastrointestinal motility drug and vancomycin(P<0.05). Logistic regression analysis showed that the gastrointestinal motility drug was the independent influencing factor for the C.difficile infection;vancomycin was the independent preventive factor for the C.difficile infection. CONCLUSION The test of C.difficile infection can be considered as a routine examination for the ICU patients. Whether the gastrointestinal motility drug is a risk factor for the C.difficile infection needs to be further studied.