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Received:October 24, 2022 Published Online:July 19, 2023
Received:October 24, 2022 Published Online:July 19, 2023
中文摘要: 目的 分析影响老年艰难梭菌感染（CDI）患者的危险因素及30 d内生存情况。
方法 回顾性分析2018年6月至2022年6月河北省人民医院60岁以上腹泻患者311例的临床资料，根据患者是否感染艰难梭菌，分为艰难梭菌阳性组（141例）及艰难梭菌阴性组（170例），结合临床和实验室资料，分析CDI危险因素及生存情况。
结果 多因素logistic回归分析发现，C-反应蛋白（CRP）增高、大便潜血阳性、抗菌药物使用天数≥7d、3个月内住院史、肠镜检查是老年患者CDI发生的独立危险因素（P<0.05）。艰难梭菌阳性组与阴性组患者入院30 d内生存率差异无统计学意义（P>0.05）。
结论 老年患者CDI发生风险较高，尤其对存在CRP增高、便潜血阳性、3个月内住院史、住院期间抗菌药物使用天数≥7 d、行肠镜检查患者应加强艰难梭菌检测。
Abstract:Objective To analyze the risk factors affecting the elderly patients with Clostridium difficile infection (CDI) and their survival within 30 days. Methods The clinical data of 311 patients with diarrhea over 60 years old in the Hebei General Hospital from June 2018 to June 2022 were retrospectively analyzed. According to whether the patients were infected with Clostridium difficile (CD), they divided into CD-positive group (141 cases) and CD-negative group (170 cases). The risk factors and survival of CDI were analyzed combined with clinical and laboratory data.
Results The multivariable logistic regression analysis revealed that high C-reactive protein (CRP) levels, positive fecal occult blood, antibiotics use for≥7 days, hospitalization history within 3 months, and colonoscopy were independent risk factors for CDI in elderly patients (P<0.05). There was no statistically significant difference in survival rate within 30 d of admission between the CD-positive group and CD-negative group (P＞0.05).
Conclusion The risk of CDI is higher in elderly patients, especially for those with elevated CRP, positive fecal occult blood, a hospitalization history within 3 months, antimicrobial use for≥7 days during hospitalization, and those undergoing colonoscopy, it is necessary to strengthen the detection of CD.
文章编号： 中图分类号：R378.8 文献标志码：B
基金项目:河北省医学科学研究课题(20190019)
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