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难辨梭状杆菌是引起医源性腹泻的主要致病菌,为评价目前对该菌的检测方法,探讨诊断标准,加拿大有关部门在1995年对全国380所医院和省级实验室进行了难辨梭状杆菌检出率及诊断方法的调查。 调查者将调查表分送给床位在50张以上的380所医院,调查表的回收率为63％。在少于300张床位、300～500张床位和500张以上床位的医院中分别有17.6％、61.5％和74.2％进行了难辨梭状杆菌的室内检测,检测的平均阳性率分别为17.2％、15.3％和13.2％。在100～199张床位的医院平均阳性 率较高(18.6％),而500～599张床位的医院则较低(10.3％)。以三级保健、社区保健与全科医疗为主体的医院中,平均阳性率为15％;老年病医学中心的阳性率较低。在加拿大,平均每10万门诊病人或每1000例住院病人中,难辨梭状杆菌感染的日发病率以三级保健医院为最高,全科医院、社区保健医院、老年病医院与其它医疗中心次之。在少于300张床位、300～500张床位和500张床位以上的医院中,每10万病人的平均日发病率分别为23.5、30.8和40.3例。 难辨梭状杆菌的检测方法各家不一。在进行室内检测的81所医院中,用组织培养进行细胞毒素检测的占44.4％;用ELISA测定的占38.3％;产毒难辨梭状杆菌培养检测的占32.1％;用乳胶凝集试验检测的占13.6％。 从这项?
Clostridium difficile is the main causative agent of iatrogenic diarrhea. To evaluate the current testing methods for this bacterium and explore the diagnostic criteria, the relevant departments in Canada conducted a difficult task in 380 hospitals and provincial laboratories nationwide in 1995 Investigation on detection rate and diagnosis of Clostridium. Investigators distributed the questionnaire to 380 hospitals with more than 50 beds. The response rate of the questionnaire was 63%. The detection of Clostridium difficile in 17.6%, 61.5% and 74.2% of the hospitals with less than 300 beds, 300 ~ 500 beds and more than 500 beds, respectively. The average positive rates of detection were 17.2% , 15.3% and 13.2% respectively. The average positive rate was higher in hospitals with 100 to 199 beds (18.6%) and lower (10.3%) in hospitals with 500 to 599 beds. In tertiary care, community health care and general hospital as the mainstay of the hospital, the average positive rate was 15%; Geriatric Diseases Medical Center, the lower the positive rate. In Canada, the average incidence of Clostridium difficile infection per 100,000 outpatients per 1,000 inpatients is highest among tertiary care hospitals, and general hospitals, community health hospitals, geriatric hospitals and other medical centers Second. In less than 300 beds, 300 to 500 beds and more than 500 beds in hospitals, the average daily morbidity rates per 100,000 were 23.5, 30.8 and 40.3, respectively. Clostridium difficile detection methods vary from one family to another. Of the 81 hospitals conducting in-house testing, 44.4% of cytotoxins were detected by tissue culture, 38.3% by ELISA, 32.1% by C. difficile culture, and Accounting for 13.6%. From this?