中国感染控制杂志2025，Vol.24Issue(7)：883-889,7.DOI:10.12138/j.issn.1671-9638.20252062
艰难梭菌复发感染的早期识别和合理治疗
Early identification and rational treatment of recurrent Clostridioides difficile infection
摘要
Abstract
To analyze the clinical data of patients with recurrent Clostridioides difficile infection(rCDI)in the southwestern region,and help clinicians identify high-risk populations early and adopt appropriate treatment strate-gies.Methods Clinical data of rCDI cases from a tertiary first-class hospital in southwest China from July 2019 to June 2024 were collected,and their host-related risk factors,exogenous risk factors,treatment schemes,and end-point outcomes were analyzed.Results In the past five years,a total of 26 cases of rCDI were detected from a ter-tiary first-class hospital in southwest China,accounting for 4.04％of the total positive cases(n=643)detected during the same period.19.23％of the recurrent patients experienced a second recurrence.The median age of rCDI patients was 66.5 years old,with males accounting for 73.08％.The major comorbidity included diabetes mellitus(34.62％),malignant tumors(30.77％),and chronic renal diseases(23.08％).In the 8 weeks before the first on-set of rCDI in patients,the top three drugs used were β-lactam and enzyme inhibitor compound(69.23％),proton pump inhibitors(65.38％),and carbapenems(46.15％).In the initial treatment of recurrent patients,3.85％(1/26)of the cases were treated with metronidazole,19.23％(5/26)of the cases received non-standard vancomy-cin/norvancomycin treatment in usage or dosage,46.15％(12/26)of the cases received treatment with course less than 10 days.In the treatment of the first recurrence,34.78％(8/26)of the cases received treatment with course less than 10 days.Conclusion For elderly patients and patients with diabetes mellitus,malignant tumors,and chronic renal diseases,who have used β-lactam and enzyme inhibitor compound,proton pump inhibitors,carbapene-ms within 8 weeks before disease onset,standard dose and treatment course of vancomycin or norvancomycin are recommended under permitted conditions,so as to reduce the risk of recurrence.关键词
艰难梭菌复发感染/临床特征/危险因素/合理治疗/CDIKey words
recurrent Clostridioides difficile infection/clinical characteristics/risk factor/rational treatment/CDI分类
医药卫生引用本文复制引用
李文君,陆鑫,权敏,黄文治,王晓辉..艰难梭菌复发感染的早期识别和合理治疗[J].中国感染控制杂志,2025,24(7):883-889,7.基金项目
国家自然科学基金面上项目(82072315) （82072315）
