炎症性肠病患者中Clostridioides difficile感染的分子类型和临床特征:一项回顾性研究
Jiayiren Li1, Jing Yang1, Zirou Ouyang1
1Hebei Provincial Center for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, China.
在中国的炎症性肠病 (IBD) 患者中,硬肠杆菌感染 (CDI) 较为常见. 识别分子类型和诸如住院和药物等危险因素是改善IBD护理中CDI预防的关键.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 微生物学 微生物学
背景情况:
- 艰难菌感染 (CDI) 对炎症性肠病 (IBD) 患者构成重大威胁,往往导致预后较差.
- 关于中国IBD患者中CDI的分子流行病学和临床特征的数据有限.
研究的目的:
- 研究来自中国IBD患者的C. difficile分离物的分子类型和临床特征.
- 为了比较IBD患者和非IBD患者中CDI的发病率.
- 确定与IBD患者中CDI发展相关的风险因素.
主要方法:
- 收集便样本用于无氧培养,测试C. difficile毒素A/B和谷氨酸脱酶.
- 对有毒原体分离物进行了多位置序列类型化 (MLST) 和抗菌感应性测试.
- 收集临床数据以比较患者群体并确定CDI风险因素.
主要成果:
- 与非IBD患者 (9.0%) 相比,IBD患者 (27.2%) 的CDI发病率要高得多.
- 在IBD患者中主要的序列类型 (ST) 包括ST54,ST2,ST3和ST42.
- 在ST37,ST35和ST42中观察到高的多药耐药率.
- 在IBD患者中,CDI的独立风险因素是最近住院和使用5-氨基酸,以及PPI,免疫抑制剂和皮质类固醇.
结论:
- 在IBD患者中,CDI发生的频率明显高于一般非IBD人群.
- 在住院患者中加强对CDI的监测对于减轻IBD患者的发病率至关重要.
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