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2017年—2019年某三甲医院老年艰难梭菌感染患者的毒素基因及耐药性分析

Analysis of toxin genes and drug resistance in elderly patients with Clostridium difficile infection in the grade-A tertiary hospital from 2017 to 2019
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摘要 目的探讨2017年—2019年某三甲医院老年艰难梭菌感染患者的毒素基因分型及耐药性。方法选择2017年—2019年反复性腹泻老年患者154例作为研究对象,采集患者粪便标本,采用酶联免疫荧光法鉴定标本内艰难梭菌,探究艰难梭菌感染患者的毒素基因分型及耐药特征。结果154例粪便标本中,检测出艰难梭菌定植的48例,占比为31.17%。艰难梭菌对红霉素、头孢曲松、阿奇霉素、四环素存在较高耐药性,耐药率均>88%;艰难梭菌对静脉用青霉素、甲硝唑、万古霉素均无耐药性。结论2017年—2019年三甲医院老年艰难梭菌感染定植率高,艰难梭菌对红霉素、头孢曲松、阿奇霉素、四环素存在较高耐药性;艰难梭菌对静脉用青霉素、甲硝唑、万古霉素均无耐药性,抗感染效果更佳。 Objective To investigate the toxin genotyping and drug resistance of elderly patients with Clostridium difficile infection in the grade-A tertiary hospital from 2017 to 2019.Methods A total of 154 elderly patients with recurrent diarrhea in our hospital from May 2017 to May 2019 were selected as the research objects.Stool specimens of patients were collected,and enzyme-linked immunofluorescence was used to identify Clostridium difficile in the specimens,and to explore the toxin genotyping and drug resistance characteristics of elderly Clostridium difficile infection patients in tertiary hospitals.Results Among 154 stool specimens,48 cases of Clostridium difficile colonization were detected,accounting for 31.17%.Clostridium difficile is highly resistant to erythromycin,ceftriaxone,azithromycin and tetracycline,and the drug resistance rate is>88%;Clostridium difficile is not resistant to intravenous penicillin,metronidazole,and vancomycin.Conclusion The colonization rate of Clostridium difficile infection in the elderly in the grade-A tertiary hospital from 2017 to 2019 is high.Clostridium difficile is highly resistant to erythromycin,ceftriaxone,azithromycin and tetracycline;Intravenous penicillin,metronidazole,and vancomycin are all non-resistant,and the anti-infection effect is better.
作者 骆瑛 侯乐萍 张丹 LUO Ying;HOU Le-ping;ZHANG Dan(North Ward,Hangzhou First People's Hospital(Hangzhou Geriatric Hospital),Hangzhou,Zhejiang 310000,China)
出处 《中国卫生检验杂志》 CAS 2021年第17期2090-2092,2122,共4页 Chinese Journal of Health Laboratory Technology
基金 浙江省医药卫生科技计划项目(2018KY644)。
关键词 三甲医院 老年 艰难梭菌 毒素基因 耐药性 Grade-A tertiary hospital Old age Clostridium difficile Toxin gene Drug resistance
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