四川医学2026，Vol.47Issue(4)：403-409,7.DOI:10.16252/j.cnki.issn1004-0501-2026.04.009
联合生物信息学和临床回顾性研究评估艰难梭菌毒素A/B对艰难梭菌感染所致腹泻的临床诊断价值
Diagnostic Values of Clostridium Difficile Toxin A/B in Diarrhea Caused by Clostridium Difficile Infection:A Com-bined Bioinformatics and Clinical Retrospective Study
摘要
Abstract
Objective To comprehensively evaluate clinical diagnostic values of Clostridioides difficile Toxin A/B in diar-rhea resulting from C.difficile infection through an integrated approach of bioinformatics and retrospective clinical studies.Methods This research systematically examined the genomic data of C.difficile strains uploaded to the NCBI Genome database up to Septem-ber 2024.The analysis included molecular typing,construction of phylogenetic trees,and investigation of the distribution character-istics of resistance and virulence genes among 1,573 C.difficile strains.Moreover,a retrospective analysis was carried out on the clinical data of 699 patients experiencing mild or more severe diarrhea to explore the relationship between the detection of Toxin A/B and the patients'clinical symptoms.Results Based on the 95 sequence types(STs)identified from the 1,573 C.difficile ge-nomes,phylogenetic tree analysis indicated that C.difficile could be classified into five major clades.Clade 1,represented by ST3,accounted for 5.85％ and had the highest number of ST types.Clade2,represented by ST1,made up 10.49％.Clade3 included ST285,with a proportion of 0.03％.Clade 4,represented by ST39,accounted for 0.33％.Clade 5 was represented by ST36 and ST37,each accounting for 0.13％.Resistance gene analysis showed that the cdeA gene was found to be highly prevalent across all ST types,accounting for 94.74％.Its encoded product is associated with various drug-efflux transporters.Vancomycin resistance genes showed significant evolutionary clustering,spanning all evolutionary branches,while other resistance gene categories exhibited weaker clustering.Clinical retrospective clinical analysis found that A significant positive correlation was observed between the se-verity of diarrhea and the detection rate of Toxin A/B(contingency coefficient,CC=0.646).Elderly patients infected with C.diffi-cile showed higher virulence,were more prone to develop severe diarrhea.Additionally,the use of antibiotics was positively correla-ted with the detection rate of Toxin A/B and the positive rate of C.difficile(contingency coefficient,CC=0.407).Conclusion Results of Toxin A/B testing are significantly correlated with the severity score of patients'diarrhea,further validating the crucial role of Toxin A/B in assessing the onset of disease after C.difficile infection.This study provides substantial evidence supporting Toxin A/B as an important biomarker for the diagnosis of Clostridium difficile-associated diarrhea(CDI)and highlights its signifi-cance in the clinical diagnostic process.关键词
艰难梭菌/毒素A/B/抗生素/腹泻Key words
clostridioides difficile/Toxin A/B/antibiotics/diarrhea分类
医药卫生引用本文复制引用
郭靓,汪璐,强雪芹..联合生物信息学和临床回顾性研究评估艰难梭菌毒素A/B对艰难梭菌感染所致腹泻的临床诊断价值[J].四川医学,2026,47(4):403-409,7.基金项目
成都医学院临床科研基金项目(编号:2020LHJYPJ-03) （编号:2020LHJYPJ-03）
