- 期刊
- OpenAccess
39例成人住院艱難擬梭菌感染相關性腹瀉的臨床特徵分析
Clinical characteristics of Clostridioides difficile-associated diarrhea: analysis of 39 adult inpatients
摘要
目的：了解目前澳門鏡湖醫院的成人艱難擬梭菌感染相關性腹瀉（CDAD）流行情況、臨床特徵、危險因素及診治現狀，為臨床防治提供依據。方法：回顧性分析2017年7月1日至2022年6月30日期間澳門鏡湖醫院CDAD成人住院患者的一般情況及臨床特點。結果：共39例CDAD患者，檢出率為同期住院患者的萬分之3.6；老齡患者佔79.3%，超過九成患者有基礎疾患，近90%的患者有抗生素使用史，近7成患者有質子泵抑制劑使用史；治療方案多採用Metronidazole或Vancomycin，76.9%患者治療當天症狀有明顯改善。結論：老齡、具基礎疾病、有抗生素或質子泵抑制劑使用史均為CDAD的高危因素；對高危腹瀉患者艱難擬梭菌檢測的重視以及對抗生素和質子泵抑制劑的合理使用，有利於CDAD的防治。
並列摘要
Objective: To investigate the incidence, clinical characteristics and risk factors for Clostridioides difficile-associated diarrhea (CDAD) in adult inpatients in Kiang Wu Hospital to provide the basis for clinical prevention and treatment. Methods: The retrospective survey was conducted to analyse the general condition and clinical characteristics in adult inpatients in Kiang Wu Hospital between 2017/7/1 and 2022/6/30. Result: 39 cases was diagnosed CDAD with the detection rate of 0.036%. Elderly patients accounted for 79.3%. More than 90% cases had underlying diseases, approximately 90% cases with a history of antibiotic use and nearly 70% cases had a history of proton pump inhibitor (PPI) use. Metronidazole and Vancomycin were the most frequently used antibiotics. Symptoms improved significantly in 76.9% patients on the day of treatment. Conclusion: older age, underlying diseases and a history of the use of antibiotics or PPI are high-risk factors for CDAD. Awareness of Clostridioides difficile infection in high-risk diarrhea patients and reasonable use of antibiotics helps in the prevention and treatment of CDAD.