Pathogen Detection Of Clostridium Difficile And AAD Investigation In Intensive Care Unit

ORJCTIVE(1) The objective is to study the isolating rate of Clostridium difficile of ICU hospitalized patients occur with antibiotic-associated diarrhea (AAD).(2) To analyse various factors of diarrhea caused by Clostridium difficile associated diarrhea(CDAD) and non-Clostridium difficile-associated but antibiotic-associated diarrhea, clearly identify its different risk factors and clinical characteristics.METHODSDuring Oct2012-Mar2013,the patients in a hospital ICU (including the central ICU, neurosurgical ICU, neurology ICU, respiratory ICU, emergency ICU)were prospectively monitored in strict accordance with case inclusion and exclusion criteria. Investigated the patients with antibiotic-associated and cultured the stool specimens for anaerobic,if it was Clostridium difficile.CDAD and non-CDAD but antibiotic associated diarrhea patients were grouped on a variety of factors. Analysed the differences of clinical characteristics and risk factors by Chi-square test and t test.RESULTS During the6month investigation, a total of1322cases of ICU hospitalized patients,82were AAD,the incidence of AAD was6.2%(82/1322);8(9.8%,8/82)Clostridium difficile had been cultured from82cases of antibiotic-associated diarrhea stool specimens. The incidence of CD AD of hospital ICU ward was61/100,000(8/1322). For the82cases AAD,56cases was male (68.29%),26cases was females (31.70%), mean age was54.31±19.67year, the underlying diseases mainly were19cerebral hemorrhage of cases (23.17%),16cases of malignant (19.51%),13cases of severe pneumonia (15.85%). All the AAD patients were prescribed cephalosporins, broad-spectrum penicillins, quinolones, carbapenems and other broad-spectrum antimicrobial drugs for one or more,and the average use day of antimicrobial were7.26±7.26days. There were no statistically significant difference between two groups of patients with risk factors:age, gender,type of antibiotic use, antibiotics combined condition, antibiotics use of days, whether use of proton pump inhibitors and other factors and two groups of patients with clinical features:fever, diarrhea times,with or without abdominal pain, vomiting, blood wbc.CONCLUSION:The incidence of CDAD in hospital ICU ward was relatively low. CDAD and non-CD AD antibiotic-associated diarrhea in patients with risk factors and clinical manifestations, were not statistically different. It is difficult to distinguish the two disease from the correlation of risk factors and clinical manifestations. The pathogen culture was a effective method to identify CDAD.