本文選題：艱難梭菌 + 培養(yǎng)�。� 參考：《中華醫(yī)院感染學(xué)雜志》2017年19期

【摘要】：目的研究2014-2016年醫(yī)院艱難梭菌感染情況。方法 2014年6月-2016年5月,臨床標本的毒素檢測采用酶聯(lián)免疫法(EIA);隨機選擇69例非重復(fù)住院患者的毒素送檢糞便同時進行EIA、GeneXpert PCR和艱難梭菌培養(yǎng)并比較,結(jié)合病歷回顧研究培養(yǎng)和/或毒素陽性患者的感染及治療。結(jié)果艱難梭菌培養(yǎng)和毒素檢測同時送檢的非重復(fù)患者640例,85例培養(yǎng)或/和毒素陽性,培養(yǎng)陽性率為8.91%,毒素陽性率為7.97%;培養(yǎng)陽性率10%的科室有胃腸外科、腎內(nèi)科、風(fēng)濕免疫內(nèi)科、消化內(nèi)科;毒素陽性率10%的科室有腎內(nèi)科、骨腫瘤科、風(fēng)濕免疫內(nèi)科、胃腸外科、消化內(nèi)科。標本送檢占比56.88%的血液科,其培養(yǎng)、毒素陽性率僅分別為8.24%、5.49%;隨機選擇的69例非重復(fù)患者標本,有9例屬于艱難梭菌感染,陽性率為13.04%,培養(yǎng)的靈敏度、特異度分別為66.67%、98.33%;EIA的靈敏度、特異度分別為44.44%、93.33%;PCR的靈敏度、特異度分別為100%、95.00%;相關(guān)因素分析,"腹瀉時長≥48h"、"每日腹瀉≥3次"在艱難梭菌感染組與非感染組中具有顯著性差異;培養(yǎng)陽性或毒素陽性均有陽性提示意義,若伴隨腹瀉癥狀,應(yīng)重點考慮艱難梭菌感染并予以萬古霉素、甲硝唑和/或腸道菌群調(diào)節(jié)藥物。結(jié)論應(yīng)規(guī)范送檢標本,選擇合適檢驗方法,重視艱難梭菌感染,避免其成為我國的公共健康威脅。
[Abstract]:Objective to study the infection of Clostridium difficulty in hospital from 2014-2016. Methods Enzyme-linked immunosorbent assay (Elisa) was used to detect the toxin in clinical samples from June 2014 to May 2016, and the feces of 69 non-repeated hospitalized patients were randomly selected to be cultured with EIA-GeneXpert PCR and Clostridium difficult. The infection and treatment of culture and / or toxin positive patients were studied retrospectively. Results the positive rates of culture and toxin were 8.91 and 7.97 respectively in 640 cases of non-repetitive patients, including gastrointestinal surgery, nephrology and rheumatism immunology, in which the positive rate of culture was 8.91, and the positive rate of toxin was 7.97.The positive rate of culture was 10% in the department of gastrointestinal surgery, nephrology and rheumatism immunology. The positive rate of toxin is 10% in the Department of Kidney, Bone Oncology, Rheumatological Immunology, Gastrointestinal surgery, and Gastroenterology. The positive rate of toxin in culture was only 8.24% and 5.49% in hematology, 9 of 69 randomly selected non-repetitive patients were infected by Clostridium diffracta, and the positive rate was 13.04. The sensitivity and specificity of culture were 66.67% and 98.33, respectively. The sensitivity and specificity of PCR were 100 and 95.00, respectively, the relative factor analysis showed that "diarrhea time 鈮，

本文編號：1827908