The medical records of 84 patients with stool cultures positive for Clostridium difficile during the period August 2007 to June 2009 were retrospectively reviewed. A case of confirmed (toxigenic)C. difficile infection (CDI) was defined by the presence of symptoms (fever, diarrhoea, abdominal discomfort or distension, ileus) and the presence of toxigenic C. difficile. Patients with compatible clinical symptoms and stool cultures positive for non-toxigenic C. difficile isolates were defined as probable (non-toxigenic) CDI cases. Of these 84 patients, 50 (59.5%) were diagnosed as confirmed CDI and 34 (40.5%) as probable CDI. Thirteen (15.5%) of the 84 patients died during their hospital stay. Usage of proton pump inhibitors was a significant independent risk factor for CDI (OR 3.21, P=0.014). Of the 50 isolates associated with confirmed CDI, seven (8.3%) carried binary toxin genes (cdtAB), and six (7.1%) had a deletion in the tcdC gene. The mortality rate in confirmed CDI patients with isolates exhibiting deletion in the tcdC gene (2/6, 33.3%), those with isolates harbouring binary toxin genes (2/7, 28.6%), and those with isolates containing mutations in gyrA (2/7, 28.6%) and gyrB (1/2, 50%) was higher than the overall mortality rate (10/50, 20%) in patients with confirmed CDI.

译文

回顾性分析了2009年6月2007年8月84例粪便培养为艰难梭菌阳性的患者的病历。1例确诊 (有毒) 艰难梭菌感染 (CDI) 的定义是症状 (发热,腹泻,腹部不适或腹胀,肠梗阻) 和产毒艰难梭菌的存在。具有相容的临床症状和粪便培养的非产毒艰难梭菌分离株阳性的患者被定义为可能的 (非产毒的) CDI病例。在这84名患者中,50名 (59.5% 名) 被诊断为CDI确诊,34名 (40.5% 名) 被诊断为CDI可能。84名患者中有13名 (15.5% 名) 在住院期间死亡。质子泵抑制剂的使用是CDI (或3.21,P = 0.014)。在与确诊CDI相关的50个分离株中,7个 (8.3% 个) 携带二元毒素基因 (cdtAB),6个 (7.1% 个) tcdC基因缺失。死亡率在确诊的CDI患者中,分离株显示tcdC基因缺失 (2/6,33.3%),具有二元毒素基因的分离株 (2/7,28.6%) 和具有gyrA (2/7,28.6%) 和gyrB (1/2,50%) 突变的分离株高于确诊CDI患者的总死亡率 (10/50,20%)。

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