James A H, Katz V L, Dotters D J, Rogers R G
Department of Obstetrics/Gynecology, University of North Carolina School of Medicine, Chapel Hill, USA.
South Med J. 1997 Sep;90(9):889-92. doi: 10.1097/00007611-199709000-00004.
We reviewed hospital records of women on the obstetrics and gynecologic services with a diagnosis of antibiotic-associated diarrhea, pseudomembranous colitis, or Clostridium difficile infection to better characterize the incidence and course of women with C difficile infection. Cases were included if there was identification of C difficile by culture or toxin or endoscopic verification of pseudomembranous colitis. Between January 1985 and June 1995, there were 74,120 admissions to the obstetrics and gynecology services at two tertiary level hospitals. Eighteen women were found to have documented C difficile infection (0.02%)--3 from the obstetric services, 10 from the benign gynecologic services, and 5 from the gynecologic/oncology services. Diarrhea developed from 2 days to 30 days after antibiotics had been given (mean, 10 days). Nine patients had fever, six had nausea and vomiting, and five had abdominal pain. Antimicrobial agents given before infection included cephalexin, cefoxitin, imipenem, ciprofloxacin, trimethoprim/sulfamethoxazole, ampicillin, gentamicin, and clindamycin. All patients were treated successfully with inpatient antimicrobial agents-15 with metronidazole and 3 with vancomycin. There was one possible recurrence.
我们查阅了妇产科服务中诊断为抗生素相关性腹泻、伪膜性结肠炎或艰难梭菌感染的女性患者的医院记录，以更好地描述艰难梭菌感染女性患者的发病率和病程。如果通过培养或毒素鉴定出艰难梭菌或通过内镜检查证实为伪膜性结肠炎，则纳入病例。1985年1月至1995年6月期间，两家三级医院的妇产科服务共收治了74120名患者。发现18名女性有记录的艰难梭菌感染（0.02%）——3名来自产科服务，10名来自良性妇科服务，5名来自妇科/肿瘤科服务。腹泻在使用抗生素后2天至30天出现（平均10天）。9名患者发热，6名患者恶心呕吐，5名患者腹痛。感染前使用的抗菌药物包括头孢氨苄、头孢西丁、亚胺培南、环丙沙星、甲氧苄啶/磺胺甲恶唑、氨苄西林、庆大霉素和克林霉素。所有患者均通过住院使用抗菌药物成功治疗——15名使用甲硝唑，3名使用万古霉素。有1例可能复发。
