Schwaber M J, Simhon A, Block C, Roval V, Ferderber N, Shapiro M
Department of Clinical Microbiology and Infectious Diseases, Hadassah University Hospital, Jerusalem, Israel.
Eur J Clin Microbiol Infect Dis. 2000 Jan;19(1):9-15. doi: 10.1007/s100960050002.
A prospective survey of the adult inpatient population of an urban tertiary care hospital was conducted to determine factors associated with the development of nosocomial diarrhea and the acquisition of Clostridium difficile-associated disease. During the 3-month survey, 98 patients with nosocomial diarrhea were enrolled, and 38 controls were recruited. The controls were patients without diarrhea lying in beds adjacent to the affected patients. Factors significantly associated with nosocomial diarrhea were the administration of a special diet (P=0.02) and receipt of a greater number of different antibiotics (P=0.02). Among the 98 patients with diarrhea, Clostridium difficile toxin B was identified in the stool of 13. Factors found to be associated with the presence of toxin B as compared to other causes of nosocomial diarrhea were a greater number of individual antibiotics used during hospitalization (P=0.02) and receipt of a cephalosporin (P=0.03) or, more specifically, a third-generation cephalosporin (P=0.02). Among patients with nosocomial diarrhea, those who had toxin in their stool had a significantly higher total antibiotic burden (expressed as antibiotic days) than those with diarrhea due to other causes (P=0.01).
对一家城市三级护理医院的成年住院患者进行了一项前瞻性调查，以确定与医院获得性腹泻的发生及艰难梭菌相关疾病的获得有关的因素。在为期3个月的调查中，纳入了98例医院获得性腹泻患者，并招募了38名对照。对照为与受影响患者相邻床位的无腹泻患者。与医院获得性腹泻显著相关的因素是给予特殊饮食（P=0.02）和接受更多种类的不同抗生素（P=0.02）。在98例腹泻患者中，13例患者的粪便中检测到艰难梭菌毒素B。与医院获得性腹泻的其他病因相比，发现与毒素B存在相关的因素是住院期间使用的个别抗生素种类更多（P=0.02）以及接受头孢菌素治疗（P=0.03），更具体地说是接受第三代头孢菌素治疗（P=0.02）。在医院获得性腹泻患者中，粪便中有毒素的患者的总抗生素负担（以抗生素使用天数表示）显著高于其他原因导致腹泻的患者（P=0.01）。
