一岁以上住院儿童相关腹泻的分布及危险因素分析。
Distribution and risk factor analysis for -associated diarrhea among hospitalized children over one year of age.
作者信息
Zhao Chunna, Guo Shu, Jia Xiaoyun, Xu Xiwei
机构信息
Department of Gastroenterology Beijing Children' s Hospital Faculty of Digestive Diseases Capital Medical University National Clinical Research Center f or Digestive Diseases Beijing 100045 China.
出版信息
Pediatr Investig. 2019 Oct 28;4(1):37-42. doi: 10.1002/ped4.12155. eCollection 2020 Mar.
IMPORTANCE
associated diarrhea (CDAD) is a severe type of antibiotic-associated diarrhea (AAD). However, the risk factors for CDAD in children with AAD have not yet been clarified.
OBJECTIVE
To investigate the distribution and risk factors for CDAD among hospitalized children in Beijing Children's Hospital.
METHODS
Stool samples from 197 children with AAD were tested for the pathogenic genes ( and ) using polymerase chain reaction between January 2011 and January 2014. Children who tested positive for or were included in the CDAD group, and those remaining comprised the non-CDAD group.
RESULTS
The rate of CDAD among the 197 children with AAD was 42.6% (84/197). The age distribution was 1-15.6 years, among which the majority of children (54.8%, 46/84) were aged 1-4 years. Differences in the CDAD-positive rates among AAD children belonging to different age groups were not statistically significant. Univariate analysis revealed that the duration of antibiotic therapy, the length of hospitalization prior to diarrhea, and gastrointestinal tract operations were significant risk factors ( 0.05). Children with CDAD underwent more antibiotic therapy and had longer periods of hospitalization prior to diarrhea onset than children in the non-CDAD group. Using multivariate regression analysis, hospitalization for ≥ 10 days prior to diarrhea was found to be an independent risk factor for CDAD.
INTERPRETATION
This study revealed that the length of hospitalization (≥ 10 days) prior to diarrhea was an independent risk factor for CDAD in children with AAD.
重要性
艰难梭菌相关性腹泻（CDAD）是一种严重的抗生素相关性腹泻（AAD）。然而，AAD患儿发生CDAD的危险因素尚未明确。
目的
调查北京儿童医院住院患儿中CDAD的分布情况及危险因素。
方法
2011年1月至2014年1月期间，对197例AAD患儿的粪便样本采用聚合酶链反应检测致病基因（和）。检测或呈阳性的患儿纳入CDAD组，其余患儿组成非CDAD组。
结果
197例AAD患儿中CDAD发生率为42.6%（84/197）。年龄分布为1至15.6岁，其中大多数患儿（54.8%，46/84）年龄在1至4岁。不同年龄组的AAD患儿中CDAD阳性率差异无统计学意义。单因素分析显示，抗生素治疗时间、腹泻前住院时间和胃肠道手术是显著的危险因素（0.05）。与非CDAD组患儿相比，CDAD患儿接受的抗生素治疗更多，腹泻发作前住院时间更长。多因素回归分析显示，腹泻前住院≥10天是CDAD的独立危险因素。
解读
本研究表明，腹泻前住院时间（≥10天）是AAD患儿发生CDAD的独立危险因素。
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