5例脑血管疾病患者艰难梭菌感染的治疗分析

Treatment of Clostridium difficile infection in 5 patients with cerebrovascular diseases

目的探讨艰难梭菌感染的临床特点及治疗对策。方法回顾分析某大型综合医院神经内科收治的5例艰难梭菌感染的住院病例的临床资料。结果广谱抗菌药物所致的艰难梭菌感染多出现于用药的1~2个月内,临床表现主要为腹泻,产毒素艰难梭菌检测阳性;发生艰难梭菌感染,立即停用广谱抗菌药物及抑酸剂,应用甲硝唑和万古霉素可有效控制感染。结论广谱抗菌药物联用质子泵抑制剂易引起艰难梭菌感染,用药后应观察大便情况,及时监测大便常规和艰难梭菌毒素。发生艰难梭菌感染时需立即停用高危药物,并采取抗艰难梭菌治疗和对症措施。

Objective To investigate the clinical characteristics of and treatment countermeasures for Clostridium difficile infection.Methods We retrospectively analyzed the clinical data of 5 patients with Clostridium difficile infection in the Department of Neurology of a comprehensive hospital.Results Most Clostridium difficile infection caused by broad-spectrum antibiotics occurred in 1-2 months,with clinical manifestations of diarrhea,and positive toxigenic Clostridium difficile.In case of Clostridium difficile infection,broad-spectrum antibiotics and antacids were stopped immediately,and replaced with metronidazole and vancomycin to effectively control the infection.Conclusion Broad-spectrum antibiotics combined with proton pump inhibitors may easily cause Clostridium difficile infection.The stool condition should be observed,and routine stool and Clostridium difficile toxin should be monitored in time.When Clostridium difficile infection occurs,the use of high-risk drugs should be stopped immediately,and anti-Clostridium difficile treatment and symptomatic measures should be taken.