炎症性肠病患者合并艰难梭菌感染的影响因素及相关预防控制策略分析OA

Objective To explore the independent risk factors of Clostridium difficile infection(CDI)in patients with inflammatory bowel disease(IBD),and to propose targeted prevention and control strategies so as to reduce the risk of CDI and improve the prognosis in IBD patients.Methods A retrospective case-control study was conducted,and 210 IBD patients treated at the First Affiliated Hospital of Nanjing Medical University from March 2023 to June 2025 were selected as the study subjects.Fresh stool samples were collected from patients for CDI screening.According to stool test results,the patients were divided into the CDI group(37 cases)and the non-CDI group(173 cases).Clinical data of the two groups were collected and compared,including general conditions,disease conditions,treatment and exposure history in the recent 3 months,and laboratory indices.Logistic regression analysis was used to identify the risk factors of concurrent CDI in IBD patients.Results The age,the proportion of recent antibiotic use,recent glucocorticoid use and recent hospitalization history,as well as C-reactive protein level in the CDI group were higher than those in the non-CDI group,while the body mass index and albumin level were lower than those in the non-CDI group(P<0.05).There were no significant differences in disease type and disease activity between the two groups(P>0.05).Logistic regression analysis showed that low albumin,high C-reactive protein,recent antibiotic use,recent glucocorticoid use,recent proton pump inhibitor use and recent hospitalization history were independent risk factors for concurrent CDI in IBD patients(P<0.05).Conclusion The incidence of CDI is relatively high in IBD patients.The main risk factors include recent use of antibiotics,glucocorticoids and proton pump inhibitors,recent hospitalization history,low albumin and high C-reactive protein.It is clinically necessary to strengthen the monitoring of high-risk patients,optimize the use of antibacterial drugs,provide nutritional support,and implement nosocomial infection control measures to reduce the risk of CDI and improve the clinical outcomes of IBD patients.