Analysis Of Risk Factors And Clinical Features Of Clostridium Difficile Infection

Objective In order to understand the situation of CDI(Clostridum difficile infections)in the hospital of Inner Mongolia Medical University,we explored the independent risk factors and clinical features of infection,especially the correlation between the use of antibiotics and CDI.Methods 1.To collect the crude sputum samples from hospitalized patients with diarrhea in the hospital of Inner Mongolia Medical University from December 2017 to November 2018,and to test the toxins of C.difficile(Clostridum difficile).Incidence and departmental distribution;2.Retrospective analysis of patients’ case data,patients with toxin-producing C.difficile infection as positive cases,and the remaining as a negative control group,through case-control study of possible risk factors such as basic information(age,sex),antibacterial drugs(penicillins,quinolones,carbapenems,glycopeptides,antifungals,anti-anaerobic bacteria),long-term drug use(antacids,glucocortic oids,salicylic acid)Drugs),underlying diseases(inflammatory bowel disease,malignant tumors,chronic obstructive pulmonary disease(COPD),diabetes,cerebrovascular disease),others(history of chemoradiotherapy,history of surgery),first univariate analysis,and then take orders Influential factors with statistical differences in factor analysis,multivariate logistic regression analysis,in which the forward selection method was used to analyze the independent risk of infection.Risk factors;3.Check the patient’s laboratory test results to check the bulb ratio,fecal occult blood and blood test for white blood cells,C-reactive protein(CRP),erythrocyte sedimentation rate(ESR),procalcitonin(PCT),plasma albumin(ALB)and hospitalization days,the clinical characteristics of C.difficile infection were obtained from the two groups by yin and yang,which can be used as clinical suspicious substitutes for infection.Results 1.Incidence rate:(1)Antibiotic-associated diarrhhoea(AAD): A total of 211 patients with diarrhea meeting the standard,including 136 patients with AAD,the in cidence of AAD in patients with diarrhea in Inner Mongolia Affiliated Hospital The rate was 64.45%(136/211);(2)the detection rate of toxigenic C.difficile infection: 30 cases of toxic clostridium infection were detected in 211 patients with diarrhea,so CDI in patients with diarrhea in Inner Mongolia Affiliated Hospital The detection ratewas 14.22%(30/211);(3)CD/AAD composition ratio: 27 cases of toxin-producing C.difficile infection were detected in 136 cases of AAD patients,so the infection of C.difficile infection in Inner Mongolia Affiliated Hospital accounted for 19.85%(27/136)of antibiotic-associated diarrhea;(4)Departmental distribution: The incidence of CDI was highest in the Department of Gastroenterology(20.39%,21/103),and the incidence of ICU,respiratory,and hematology decreased in turn.It is 18.19%(2/11),10.53%(2/19),and 8.82%(3/34).2.Univariate analysis:(1)Analysis of basic information(age,gender)factors: age >65 years was associated with CD infection rate,the difference was statistically significant(P<0.05).(2)Analysis of antibacterial factors: The use of penicillin-like cephalosporins,quinolones and anti-anaerobic bacteria was significantly different(P<0.05).(3)Analysis of long-term drug use factors: The use of antaci ds and glucocorticoids was significantly different from the infection rate(P<0.05).(4)Analysis of underlying disease factors: inflammatory bowel disease,malignant tumor,COPD and infection rate were significantly different(P<0.05).(5)Analysis of other factors: the history of radiotherapy and chemotherapy,the history of surgery and the infection rate were significantly different(P<0.05).3.Logistic multivariate regression analysis: age > 65 years old,acid suppression agent,long-term use of glucocorticoids,antibacterial drugs(quinolones,penicillins,cephalosporins),underlying diseases(inflammatory bowel disease,malignant tumors),The history of radiotherapy and chemotherapy and the history of surgery are independent risk factors for C.difficile infection.4.The blood test results of patients with elevated white blood cells,elevated CRP,elevated ESR,elevated PCT,decreased ALB and prolonged hospitalization ≥15 days were associated with CD infection rate,the difference was statistically significant(P<0.05).Conclusion 1.The incidence of antibiotic-associated diarrhea in diarrhea patients was 64.45%,and the detection rate of toxin-producing C.difficile infection was 14.22%;the toxigenic C.difficile infection accounted for 19.85% of antibiotic-associated diarrhea.The Department of Gastroenterology,ICU,Respiratory,and Hematology are the main detection departments.2,multi-factor logistic regression analysis: age > 65 years old,antacids,long-term use of glucocorticoids,antibacterial drugs(quinolones,penicillins,cephalosporins),underlying diseases(inflammatory bowel disease,malignant tumors)The history of radiotherapy and chemotherapy and the history of surgery are independent risk factors for Clostridium difficile infection.3,check the cue ratio imbalance,fecal occult blood positive and blood test white blood cells,CRP,ESR,PCT are increased,ALB decreased,hospitalization extended ≥ 15 days,especially ALB reduction,can be used as a clinical suspicious substitute for CDI.