| Objective: This research aims at exploring measures that can reduce or eliminate Clostridium difficile(CD)exotoxin A/B,and observing differences between changes in exotoxin A/B after using oral administration of Bacillus coagulans talents and traditional anti-bacterial agents to treat Clostridium difficile related diarrhea.Comparing the clinical outcomes of these two therapies provided scientific guidance for using Bacillus coagulans tablets to treat Clostridium difficile induced intestinal infection in clinical circumstances.This research also intends to reveal the current status of Clostridium difficile carriage among hospitalized patients with diarrhea and provides support for early diagnosis and treatment of Bacillus coagulans tablets.Methods:163 stool specimen were collected from hospitalized patients with diarrhea in Chongzhou People's Hospital during September 2015 and August 2016.The “two-step” method was adopted to use Clostridium difficile rapid testing kit(immune-colloidal gold technique)to test the presence of glutamate dehydrogenase(GDH)produced during the proliferation of Clostridium difficile.Then GDH positive specimens were tested for the presence of Clostridium difficile exotoxin A/B using mini Vidas Automated Immunoassay Analyzer and Clostridium difficile exotoxin A/B testing kit(enzyme-linked fluoroimmunoassay).Meanwhile,GDH positive patients were randomly put into the probiotics treatment group(experiment group),and antibiotics group(control group)using a random digits table.Patients in the experiment group were given Bacillus coagulans tablets(1050 mg per time,tid,po).Patients in the control group were given metronidazole(250 mg per time,tid,po).Stool specimens were collected from these patients after 3-7 days' treatment to test the presence of GDH and Clostridium difficile exotoxin A/B.Analysis was then performed to compare the GDH-negative conversion rate and the elimination rate of Clostridium difficile exotoxin A/B so as to the clinical effects of using Bacillus coagulans tablets to treat Clostridium difficile infections.Results: Among the 163 tool specimens collected from hospitalized patients with diarrhea,the total CD positive rate 20.86%(34/163).The seasonal CD positive rate for specimens collected during spring,summer,autumn,and winter were 16.67%,15.79%,17.86% and 27.87% respective(?2=2.943,P >0.05),showing no significant difference among different seasons.The CD positive rate for the adult group(?18 years old)was 22.52%(25/111)and 17.31%(9/52)?2=0.583,P >0.05)for the adolescent group(<18 years old)with no significant difference.The CD positive rate for the stool specimens of men and women were 21.69%(18/83)and 20.00%(16/80)(?2=0.202,p>0.05)with no significant difference.Besides,the average number of days antibacterial drugs used among CD positive patients with diarrhea was 12.74,which was larger than the 8.21 days of CD negative patients(t=7.81,P <0.01)with significant difference.The elimination rate of Clostridium difficile exotoxin A/B were 75.0% and 87.5%(Fisher: P =0.619>0.05),showing no significant difference between experiment and control group.Conclusion: CD positive rate of hospitalized patients with diarrhea were found not significantly related to factors including seasons,age,and gender,but significantly related to the number of days anti-bacterial drugs were used.CD positive rate increases as the number of days used increases.The effects of Bacillus coagulans tablets and metronidazole in eliminating GDH and Clostridium difficile exotoxin were not significantly different in treating CD-related diarrhea.Considering the benefits of Bacillus Coagulans tablets in their rapid movement to intestines,helping the reconstruction of human body's immunological barrier,absence of drug interactions and low cost,this research recommends the combined usage of anbi-biotics and probiotics for the treatment of Clostridium difficile related intestinal infections. |
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