背景:艰难梭菌是抗菌相关腹泻和医疗机构相关感染性腹泻的主要病原体。本研究旨在调查患病率,毒素基因型,西安市住院患者艰难梭菌耐药性分析中国。
结果:我们分离培养了156株艰难梭菌,占收集的1231例住院粪便样本的12.67%。在分离物中,tcdA+B+菌株占优势,占78.2%(122/156),其次是27株tcdA-B+菌株(27/156,17.3%)和6株二元毒素基因阳性菌株。三个调控基因的阳性率,tcdC,tcdR,和tcdE,为89.1%(139/156),96.8%(151/156),100%,分别。所有分离株对甲硝唑敏感,对克林霉素和头孢菌素的耐药率也很高。发现6株对万古霉素耐药。
结论:目前,西安市艰难梭菌感染(CDI)患病率为12.67%(156/1231),分离物的主要毒素基因型为tcdA+tcdB+cdtA-/B-。甲硝唑和万古霉素仍然是治疗CDI的有效药物,但是我们应该重视抗生素管理和CDI的流行病学监测。
BACKGROUND: Clostridioides difficile is the main pathogen of antimicrobial-associated diarrhoea and health care facility-associated infectious diarrhoea. This study aimed to investigate the prevalence, toxin genotypes, and antibiotic resistance of C. difficile among hospitalized patients in Xi\'an,
China.
RESULTS: We isolated and cultured 156 strains of C. difficile, representing 12.67% of the 1231 inpatient stool samples collected. Among the isolates, tcdA + B + strains were predominant, accounting for 78.2% (122/156), followed by 27 tcdA-B + strains (27/156, 17.3%) and 6 binary toxin gene-positive strains. The positive rates of three regulatory genes, tcdC, tcdR, and tcdE, were 89.1% (139/156), 96.8% (151/156), and 100%, respectively. All isolates were sensitive to metronidazole, and the resistance rates to clindamycin and cephalosporins were also high. Six strains were found to be resistant to vancomycin.
CONCLUSIONS: Currently, the prevalence rate of C. difficile infection (CDI) in Xi\'an is 12.67% (156/1231), with the major toxin genotype of the isolates being tcdA + tcdB + cdtA-/B-. Metronidazole and vancomycin were still effective drugs for the treatment of CDI, but we should pay attention to antibiotic management and epidemiological surveillance of CDI.