ICU艰难梭菌定植与感染的危险因素研究

目的探讨重症监护室(ICU)艰难梭菌定植与感染患者的危险因素,为实施有效的防控方案提供依据。方法采用前瞻性研究方法,连续收集2017年1月1日-2018年6月1日入住某院ICU患者的临床资料,采集患者粪便及其周围环境标本进行艰难梭菌检测,分析影响因素。结果多因素Logistic回归分析结果显示,年龄、质子泵抑制剂、侵入性操作、机械通气、糖尿病和β-内酰胺酶抑制剂使用是艰难梭菌的感染和定植的危险因素。结论对CDI患者进行隔离,对高龄、侵入性操作、机械通气、合并糖尿病及使用β-内酰胺酶抑制剂、质子泵抑制剂等艰难梭菌感染高危因素的患者密切关注;加强环境表面清洁消毒工作,降低艰难梭菌芽孢传播的风险,为今后研究制定艰难梭菌感染防控措施提供依据。

Risk factors study of Clostridium difficile colonization and infection in ICU

Objective To explore the risk factors of Clostridium difficile colonization and infection in intensive care unit(ICU),so as to provide basis for the implementation of effective prevention and control programs.Methods The clinical data of patients treated in ICU of a hospital from January 1,2017 to June 1,2018 were collected by prospective study method.The stool samples of patients and their surrounding environment were collected for Clostridium difficile detection,and the influencing factors were analyzed.Results Multivariate Logistic regression analysis showed that age,proton pump inhibitors,invasive manipulation,mechanical ventilation and diabetes mellitus,the use of β-lactamase inhibitor were risk factors for Clostridium difficile infection and colonization.Conclusion CDI patients should be isolated,close attention should be paid to patients with high risk factors of Clostridium difficile infection,such as aging,invasive manipulation,mechanical ventilation,diabetes mellitus and the use of beta-lactamase inhibitors,proton pump inhibitors.Environmental surface cleaning and disinfection should be strengthened to reduce the risk of Clostridium difficile spore transmission,providing basis for future research and formulation of Clostridium difficile infection prevention and control measures.