儿童艰难梭菌感染临床特征及疾病复发危险因素分析

Analysis on clinical characteristics of Clostridium difficile infection in children and risk factors of the disease recurrence

目的分析儿童艰难梭菌感染(CDI)的临床特征及疾病复发危险因素。方法选择2014年9月至2022年10月于上海市儿童医院消化感染科住院治疗的138例CDI患儿的临床资料。根据治疗后疾病复发情况将患儿分为复发组(n=39)和非复发组(n=99)。比较两组临床数据资料,并通过二元logistic回归分析CDI复发的危险因素。结果138例初发CDI患儿中男81例,女57例,中位年龄4.80岁。复发组腹泻、伪膜性肠炎和医院获得性CDI(HA-CDI)的人数比例高于未复发组,差异有统计学意义(P<0.05)。二元logistic回归分析结果显示,伪膜性肠炎和HA-CDI是促进CDI患儿复发的独立危险因素(P<0.05)。结论伪膜性肠炎和HA-CDI是住院CDI患儿复发的独立危险因素,需引起临床医师的重视。

Objective To analyze the clinical characteristics of Clostridium difficile infection(CDI)in children and the risk factors of the disease recurrence.Methods The clinical data of 138 pediatric patients with CDI who were hospitalized in the Department of Digestive Infection of Shanghai Children′s Hospital from September 2014 to October 2022 were selected.According to the disease recurrence after treatment,the pediatric patients were divided into recurrent group(n=39)and non-recurrent group(n=99).The clinical data were compared between the two groups,and the risk factors of CDI recurrence were analyzed by binary logistic regression.Results Among the 138 pediatric patients with new-onset CDI,there were 81 males and 57 females,with a median age of 4.80 years.The proportions of the pediatric patients with diarrhea,pseudomembranous colitis and hospital-acquired CDI(HA-CDI)in the recurrent group were higher than those in the non-recurrent group,and the differences were statistically significant(P<0.05).The results of binary logistic regression analysis showed that pseudomembranous colitis and HA-CDI were independent risk factors for disease recurrence in children with CDI(P<0.05).Conclusion Pseudomembranous colitis and HA-CDI are independent risk factors for disease recurrence in hospitalized children with CDI,which should be paid attention to by clinicians.