Abstract:

ObjectiveTo evaluate the construction of expression vector for fusion protein of cellpenetrating peptide CCL (PEPCCL). MethodsCCL6PEP6XHis was inserted into plasmid pABP, pABPCCL6PEP plasmid was extracted and then transfected into HEK293 cells, CCL6PEP6XHis was expressed and purified by chromatography and detected with Western Blot. ResultsPEPCCL express vector was successfully constructed and purified. PCR product of CCL6PEP6XHis Tag was ligated with T vector, recombinant was transferred into the host cells, then host cells were cultured, plasmid was extracted and sequenced, the sequence was identical to targeted gene. CCL6PEP6XHis was successfully inserted into the eukaryotic expression vector pABP, plasmid was extracted and digested, electrophoresis results revealed that a fragment with 430bp was digested by Hind Ⅲ+XbaⅠ, which was identical to the expected value. Western Blot revealed that CCL6PEP fusion protein could be recognized by His monoclonal antibody. ConclusionPEPCCL express vector can be constructed and expressed in eukaryotic cells.

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ObjectiveTo investigate the prevalence rate of healthcareassociated infection（HAI） in Xiangya Hospital，and provide reference for preventing and controlling HAI.MethodsThe cross sectional surveys on prevalence rates of HAI, crosssectional antimicrobial use, and bacterial detection among all hospitalized patients on the given days in 2000-2014 (except 2006) were carried out by combination of bedside investigation and medical record reviewing.ResultsThe prevalence rates of HAI in 2000-2014 decreased from 6.30% to 3.91%, difference was statistically significant (χ2=35.14，P＜0.001); prevalence rates of communityassociated infection（CAI）were 15.61%-15.76%, there was no significant difference among each year. General intensive care unit (ICU) had the highest prevalence rate; respiratory tract was the most common site of both HAI and CAI; urinary catheterization rate showed a decreased tendency, arteriovenous catheterization rate showed a increased tendency, difference were both significant（χ2=5.21,96.24，respectively, both P＜0.001）. In 2008-2014, pathogenic detection rates for specimens from patients receiving therapeutic antimicrobial agents were 36.37%-44.51%，from patients with HAI were 34.00%-44.99%，detection rate of pathogens causing HAI were 41.57%-68.48%,all showed a increased tendency, difference was significant (χ2=22.78， 10.03,26.49, respectively, all P<0.001). Gramnegative bacteria were the main pathogens causing infection; both cross sectional and combination antimicrobial usage rates declined （P＜0.05）.ConclusionPrevention and control of HAI,and antimicrobial management has achieved preliminary success, prevalence rate of HAI and cross sectional antimicrobial usage rate declined obviously, the main pathogen is gramnegative bacteria，and the major infection site is lower respiratory tract.

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ObjectiveTo investigate the distribution and change in antimicrobial resistance of pathogens causing bloodstream infection, so as to provide reference for rational antimicrobial use. MethodsThe isolation and antimicrobial resistance of major pathogens from blood culture specimens from a tertiary firstclass hospital in 2012-2015 were analyzed statistically. ResultsA total of 4 780 isolates were detected,  the top five species were Escherichia coli  (n=1 008, 21.09%), Klebsiella pneumoniae (n=624, 13.05%),  Acinetobacter baumannii ( n=452, 9.46%),  Staphylococcus aureus ( n=437, 9.14%), and  Pseudomonas aeruginosa (n=247, 5.17%). The percentage of gramnegative bacilli, grampositive cocci, fungi, and others were 62.05%, 29.31%,7.76%, and 0.88% respectively. The resistance rates of Klebsiella pneumoniae to ertapenem and imipenem increased from 4.50% in 2012 to 46.79% and 33.94% in 2015( both P＜0.01). The resistance rates of  Acinetobacter baumannii to cefepime, ceftazidime, tobramycin, gentamicin, and imipenem  were 86.50%, 80.56%,78.10%,79.87%, and 84.29% respectively；resistance rates to amikacin in 2012-2015 were 0,10.22%,39.85%, and 21.30% respectively（P＜0.01）；resistance rates to minocycline in four years were 0-7.52% ( P＜0.01). ConclusionThe main pathogens causing  bloodstream infection are gramnegative bacilli,  Acinetobacter baumannii is highly resistant to cephalosporins and carbapenems, resistance rates of Klebsiella pneumoniae to carbapenems increased rapidly. Broadspectrum antimicrobial agents must be used cautiously to reduce the selective pressure of antimicrobial agents.

Abstract:

ObjectiveTo evaluate clinical efficacy of tigecycline alone or in combination with other antimicrobials in treating infection caused by carbapenemresistant  Acinetobacter baumannii(CRAB). MethodsPatients with hospitalacquired pneumonia (HAP) and/or bloodstream infection in the intensive care unit of a hospital between January 2013 and June 2014 were selected, efficacy of tigecycline treatment was analyzed. ResultsOf 25 patients with CRAB infection, 21 were with HAP, 2 with bloodstream infection, and 2 with both HAP and bloodstream infection.  13 cases were multidrugresistant Acinetobacter baumannii (MDRAB), 10 cases were  extensively drugresistant Acinetobacter baumannii (XDRAB). The susceptibility rate of 25 CRAB isolates to tigecycline was 84%. After treated with tigecycline, white blood cell count(WBC),  Creactive protein (CRP), and procalcitonin (PCT) all significantly decreased (all P<0.01). The clinical effective rate, bacterial clearance rate, and 30day mortality were 68.00% (17/25), 66.67%(14/21), and 28.00% (7/25) respectively; effective rate of 21 cases of HAP was 76.19% (16/21),  1 case of bloodstream infection was effective, 2 cases of HAP combined bloodstream infection died. ConclusionTigecycline is effective in the treatment of HAP caused by CRAB, but the therapeutic effect on bloodstream remains uncertain, further research is needed.

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ObjectiveTo evaluate clinic efficacy and safety of tigecycline combined with cefoperazone/sulbactam for treatment of intracranial infection with  drugresistant Acinetobacter baumannii(DRAB).Methods12 patients with DRAB intracranial infection admitted in a department of neurosurgery between January 2014 and  April 2015 were analyzed retrospectively, clinic efficacy and safety of  tigecycline combined with cefoperazone/sulbactam for treatment of DRAB intracranial infection were evaluated. ResultsAfter patients received tigecycline combined with cefoperazone/sulbactam for 1262 days（39.5 days on average）, clinical symptoms and signs（including body temperature,  signs of meningeal irritation）of most patients were significantly improved compared with before treatment，3 cases were cured, 5 were markedly effective, 4  abandoned or ineffective(death). The overall effective rate was 66.67%（8/12），mortality was 33.33%（4/12）；bacterial clearance rate of cerebrospinal fluid (CSF) was 83.33%(10/12). Causes of death: 2 were with failure of brain stem following  craniocerebral trauma，1was extensive parenchymal infection，1was recurrence of intracranial infection and formation of  brain abscess after withdrawing antimicrobial agents. No significant adverse reaction occurred during the treatment period. ConclusionOn the basis of keeping CSF drainage unobstructed, long course treatment of tigecycline combined with cefoperazone/sulbactam can effectively eliminate DRAB from CSF, and has a good safety.

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ObjectiveTo explore the efficacy of circular wound edge protector（CWEP） in preventing surgical site infection (SSI) following open abdominal surgery,  analyze the related risk factors for postoperative SSI, and  provide scientific basis for preventing SSI following open abdominal surgery．Methods162 patients who underwent open abdominal surgery in a hospital from March 2014 to December 2015 were  randomly divided into intervention group (used CWEP during surgery) and control group (used sterile gauze pad to protect incision). Length of hospital stay，cost of dressing change,and SSI between  two groups were compared, risk factors for postoperative SSI were analyzed．ResultsIncidence of SSI in intervention group was lower than control group (14.81%［12/81］ vs 34.57%［28/81］, P＜0.05）；gradeA incision healing rate of intervention group was higher than control group(86.42% vs 66.67%， P＜0.05）. The cost of dressing change in  intervention group was lower than control group(［305.5±176.7］ yuan vs［431.6±381.4］yuan, P=0.008）. Multivariate logistic regression analysis indicated that hypoproteinemia（OR,2.88［95%CI,1.21-6.87］)， body mass index ≥24（OR,3.11［95%CI,1.12-8.66］）, and blood loss≥400 mL（OR,3.98［95%CI,1.36-11.64］） were independent risk factors for postoperative SSI, while CWEP use was the protective factor（OR,0.24［95%CI,0.09-0.59］）．ConclusionCWEP can effectively reduce the incidence of SSI following open abdominal surgery.

Abstract:

ObjectiveTo evaluate the risk factors for surgical site infection(SSI) following limb fracture surgery,  and  provide basis for making prevention and control measures. MethodsClinical data of 1 453 patients undergoing limb fracture surgery in 16 hospitals between January 1, 2014 and June 30, 2014 were collected, risk factors for SSI were analyzed by univariate and multivariate logistic regression analysis. ResultsAmong 1 453 patients undergoing limb fracture surgery, 12 developed SSI(0.83%). Univariate analysis showed that risk factors for SSI following limb fracture surgery were infection at the other sites 7 days before operation, time from injury to operation, operation opportunity, duration of operation, open fracture, wound type, and anesthesia type ( all P<0.05). Multivariate logistic regression analysis showed that independent risk factors were wound type, anesthesia type, open fracture, time from injury to operation, and duration of operation, OR(95% CI) were 12.47（2.78-15.88）,11.55（2.84-17.02）,10.79（2.72-11.13）,2.35（2.12-6.81）, and 3.07（1.88-4.13）respectively. ConclusionRisk factors for SSI following limb fracture surgery are multiple, the key to the prevention and control of SSI are identifying risk factors and strengthening the management of key points.

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ObjectiveTo understand antimicrobial resistance and therapeutic efficacy of imipenem/cilastatin and meropenem for treatment of multidrugresistant Pseudomonas aeruginosa (MDRPA) from patients with mechanical ventilation. MethodsFrom January 2010 to December 2015, 78 patients with mechanical ventilation and isolated MDRPA from sputum cultures were selected and divided into  imipenem /cilastatin (n=44) and meropenem(n=34) treatment groups, basic condition, time of  emergence  of drug resistance, and therapeutic efficacy of antimicrobial agents between two groups were compared. ResultsThe basic data of two groups were comparable, before treatment by imipenem/cilastatin and meropenem, resistance rates of Pseudomonas aeruginosa (P. aeruginosa) to quinolones, ceftazidime,  piperacillin, and amikacin were not significantly different (all P>0.05).  After patients received antimicrobial agents for 6 days, difference in antimicrobial resistance between imipenem /cilastatin  and meropenem treatment groups were not significantly different (22.73% vs 8.82%, P>0.05). On the 8th, 10th,and 12th  day of treatment,  resistance rates of imipenem treatment group were 40.91%,77.27%, and 97.73%， respectively, which were all  higher than meropenem treatment group (17.65%,32.35%,44.12%, respectively, all P<0.05）. After the treatment with different antimicrobial agents, the average time for the emergence of resistance in imipenem /cilastatin  and meropenem treatment group were 9.0 days  and 13.5 days respectively.  Therapeutic efficacy between two groups was not significantly different (64.71% vs 74.19%,P=0.41）. ConclusionCompared with meropenem, imipenem/cilastatin shows higher risk for the emergence of drug resistance during therapy of P. aeruginosa infection in patients with mechanical ventilation, there is no significant difference in therapeutic efficacy between two groups of patients after 7 days of treatment.

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ObjectiveTo implement active screening measures for patients in intensive care unit (ICU), early detect patients with multidrugresistant organism (MDRO) colonization, implement contact isolation measures,  prevent and control MDRO cross transmission. MethodsThe nasal and rectal swabs of 240 patients who were admitted to ICU from September 2012 to May 2013 were performed bacterial culture, patients with colonization of methicillinresistant Staphylococcus aureus (MRSA) ,extendedspectrum βlactamases(ESBLs)producing Escherichia coli, and ESBLsproducing Klebsiella pneumoniae were conducted contact isolation. Clinically isolated MDROs from ICU patients in September 2011-August 2012 (before active screening) and September 2012-August 2013 (after active screening) were collected and performed antimicrobial resistance analysis. ResultsOf 240 patients,  nasal swabs screening test showed that there were 56(23.33%) patients who were colonized with MRSA, including 22(39.29%) were colonized at the admission to ICU and 34(60.71%)  during the ICU stay.  Rectal swabs screening test showed that there were 105(43.75%) patients who were colonized with ESBLsproducing Escherichia coli and Klebsiella pneumoniae,  72(68.57%) were colonized at the admission to ICU, and 33(31.43%)  were colonized during the period of ICU stay. The incidence density of MDROs before and after implementing active screening were  28.56‰ and 13.71‰ respectively, difference was significant (P<0.05;RR,2.08［95%CI, 1.582-2.743］）.ConclusionMDRO colonization rate is high among ICU inpatients, implementation of comprehensive prevention and control measures against MDROs based on active screening can reduce the spread of MDROs in ICU.

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ObjectiveTo evaluate the occurrence and risk factors for healthcareassociated infection(HAI) in premature infants. MethodsThe occurrence of HAI among premature infants who were born in a hospital from January 2011 to June 2015 and admitted in the neonatal intensive care unit within 24 of birth were investigated prospectively, the related risk factors and intervention measures were analyzed. Results644 premature infants were investigated, 32(4.97%) had HAI, the main  infection site was lower respiratory tract (n=18, 56.25%).  34 pathogenic isolates causing HAI were detected, 24 (70.59%) were gramnegative bacteria, the major was Klebsiella  pneumoniae (n=14); 10 isolates were grampositive bacteria(29.41%). Logistic regression analysis revealed that small for gestational age, low birth weight,  severe amniotic fluid pollution, mechanical ventilation, feeding intolerance,  indwelling gastric tube, irrational antimicrobial use, and long  length of hospital stay were risk factors for HAI in premature infants (all P< 0.05). ConclusionRisk factors for HAI in premature infants are multiple, targeted interventions, such as shorten the length of hospital stay, reduce unnecessary invasive operation, use antimicrobial rationally,  improve the feeding tolerance, are helpful for reducing the risk factors for HAI in premature infants.

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ObjectiveTo investigate risk factors for healthcareassociated infection(HAI) in patients with aneurysmal subarachnoid hemorrhage(aSAH) in the department of neurology of a hospital. MethodsClinical data of 47 patients with aSAH who were admitted to a hospital from January 2014 to January 2015 were retrospectively analyzed. ResultsOf 47 patients with aSAH, 17 developed 19 times of HAI, HAI rate was 36.17％, case infection rate was 40.43%. The main infection site was lower respiratory tract (n=17, 89.47%), followed by urinary tract (n=2,10.53%);  2 patients had both lower respiratory tract infection and urinary tract infection. 17 patients were performed pathogenic detection, 13 pathogenic isolates were isolated from 9 patients. Multivariate nonconditional logistic regression analysis revealed that risk factors for HAI in patients with aSAH were disturbance of consciousness (OR,24.878 ［95%CI, 3.996-156.040］) and intensive care unit  admission(OR,8.645 ［95%CI, 1.419-52.670］). The prognosis of patients with HAI was poorer than those without HAI（Z=4.108，P＜0.001）. ConclusionPatients with aSAH are at high risk of HAI, it is necessary to take targeted prevention and control measures for reducing the occurrence of  HAI and promoting good prognosis.

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ObjectiveTo evaluate whether there is a correlation among plasma levels of procalcitonin (PCT), Nterminal probrain natriuretic peptide (NTproBNP) and cardiac troponin T (cTnT) in patients with sepsis, as well as significance to prognosis of patients. Methods48 patients with sepsis  who were admitted to the intensive care unit of a hospital between September 2014 and March 2015 were chosen for study, patients were divided into severe and mild sepsis groups according to the disease condition, plasma levels of PCT,  NTproBNP, and cTnT  were detected, mortality of  patients were analyzed statistically,  relation between plasma levels of PCT,  NTproBNP, cTnT and patients’ death  were compared. ResultsThe plasma levels of PCT, NTproBNP and cTnT in severe sepsis group were significantly higher than those in mild sepsis group (all P＜0.05); mortality of mild sepsis group was significantly lower than that of severe sepsis group  (10.53%  vs  41.38%,  P＜0.05);  Levels of PCT, NTproBNP and cTnT levels in died patients were all higher than surviving patients ( all P<0.05); levels of  PCT and NTproBNP,  NTproBNP and cTnT were positively correlated respectively (rs= 0.337, P＜0.05; rs＝0.456，P=0.001, respectively ), while PCT was not significantly correlated with cTnT. Plasma levels of PCT, NTproBNP, and cTnT were all correlated with the prognosis of patients (P＜0.05), and is helpful for judging the prognosis of patients, combination of three indexes had  better prognostic value for the prognosis.ConclusionCombination detection of plasmid levels of PCT, NPproBNP, and cTnT can assess the severity of infection in patients with sepsis, and preliminarily judge the prognosis of patients with sepsis.

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ObjectiveTo investigate and dispose an outbreak of seasonal influenza in hospital, so as to provide reference for the prevention and control of influenza outbreak in hospital.MethodsEight cases of influenzalike infection occurred in the department of neurosurgery at a hospital between July 29 and August 7, 2014, epidemiological investigation was conducted, throat swabs of infected persons were collected for laboratory detection.ResultsOf 8 infected persons, 6 were health care workers (HCWs) in department of neurosurgery, 1 was a family member of HCW, and 1 was a patient, the major symptoms of the infected persons were lowgrade fever, sore throat, and malaise, there were 67 patients and HCWs in this department, the attack rate of influenza was 11.94％, there was no similar infection in other departments of the hospital during the same period. The throat swabs from 6 infected HCWs were positive in influenza virus nucleic acid detection. Office for healthcareassociated  infection (HAI) management participated the investigation, after active isolation and antiviral treatment, the outbreak was effectively controlled. ConclusionThis HAI outbreak is a seasonal influenza H3 outbreak, ventilation and environmental disinfection in wards should be strengthened when central air conditioning is running, antiinfluenza vaccination among HCWs should be performed during the epidemic season of influenza,and surveillance should be strengthened to prevent influenza outbreak in hospital.

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ObjectiveTo monitor the incidence of catheterassociated infection (CAI) in patients in general intensive care unit (ICU), and provide basis for taking proper prevention and control measures.MethodsTargeted monitoring method was conducted, incidence of  healthcareassociated infection (HAI)  among patients receiving urinary catheterization, intravascular catheterization, and tracheal intubation in the general ICU of a tertiary hospital between January 2012 and December  2013 were surveyed.ResultsA total of 299 ICU patients with catheterization were investigated,  the overall hospitalization days were 2 700 days, 41 patients developed 48 episodes of HAI, incidence of  HAI was  13.71%,  case incidence was 16.05%, incidence of  HAI per 1 000 catheter days was 15.19‰,  37 patients developed 44 episodes of CAI；the other types of HAI were blood stream infection(n=1), skin and soft tissue infection(n=1), antibioticassociated diarrhea(n=1),  and herpes zoster(n=1). Incidence of catheterassociated urinary tract infection (CAUTI), catheterrelated bloodstream infection (CRBSI),and ventilatorassociated pneumonia (VAP) per 1 000 catheter days were 2.94‰，2.12‰，and 15.72‰ respectively.ConclusionCAI is the main HAI type in ICU patients with  catheterization, and the major is VAP.

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ObjectiveTo evaluate the effect of multiple intervention measures on perioperative antimicrobial use in patients undergoing typeⅠincision operation in a hospital, and provide basis for rational use of antimicrobial agents. Methods9 823 patients with type I incision operation in April and October of 2005-2012 were surveyed  retrospectively,  data of 2005 was as baseline,  from 2006 to 2012, multiple measures, including  training, examination, supervision, feedback, and cooperation of relevant departments were conducted, antimicrobial use before and after intervention was compared. ResultsThe qualified rate of perioperative antimicrobial use in patients undergoing type Ⅰ incision operation increased from 14.20% in 2006 to 92.30% in 2012; the rate of combined use of antimicrobial agents was relatively higher (7.00%-9.00%） in 2006-2009，had a downward trend in 2010- 2012, and decreased to 3.20% in 2012. Types of antimicrobial agents for prophylactic use in type Ⅰ incision operation in 2006 and 2007 were similar to that of 2005, the main used antimicrobial agents were cephalosporins, penicillin and it’s compounds, and aminoglycosides; the major antimicrobial prophylaxis in 2008-2012 were  the first and second generation cephalosporins, penicillin and it’s compounds. Multivariate nonconditional logistic regression analysis showed that age (40-59 years old), departments (orthopedics, general surgery, and ophthalmology), and years (2011 and 2012) were the main influencing factors for the qualified use of antimicrobial agents（all P＜0.05）. ConclusionImplementation of multiple intervention measures can improve the qualified rate of perioperative antimicrobial use in type Ⅰ incision operation, reduce types of antimicrobial use and rate of combined antimicrobial use.

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目的了解下呼吸道感染患者痰标本分离鲍曼不动杆菌（AB）的耐药性，为临床合理使用抗菌药物提供依据。方法分析某院2013年1月—2015年1月住院患者痰标本培养分离出的172株AB。结果172株AB中多重耐药和泛耐药菌株共128株（占74.42%）。主要分布在神经内科（56株，43.75%）、重症监护病房（44株，34.38%）。AB对米诺环素的耐药率最低（9.30%）,其次是对头孢哌酮/舒巴坦和氨苄西林/舒巴坦耐药率分别为18.60%和27.91%，对亚胺培南的耐药率为47.67%。对哌拉西林/他唑巴坦和哌拉西林的耐药率分别为62.79%、86.04%，对喹诺酮类、氨基糖苷类和第三、四代头孢菌素类的耐药率在76.74%~81.40%之间。结论AB对多种常见抗菌药物的耐药率均较高，多重耐药和泛耐药现象严重。

Abstract:

目的调查门诊和普通病房电脑鼠标不同时段的细菌污染情况。方法随机抽取某院门诊及普通病房的各16个电脑鼠标，分别于8∶00、10∶30、13∶00、15∶30进行采样，样本接种培养后对菌落计数并筛查多重耐药菌。结果32个鼠标共计采样128次，最高菌落数达121 CFU/cm2，平均菌落数为23.9 CFU/cm2。随着时间的推移，同一鼠标的细菌计数逐渐增多。不同时段门诊和病房的电脑鼠标菌落数比较，在10∶30、13∶00、15∶30三个时间点，病房鼠标的菌落数均高于门诊（均P≤0.05）。64个病房电脑鼠标标本中检出耐甲氧西林金黄色葡萄球菌（MRSA）和耐碳青霉烯类鲍曼不动杆菌（CRAB）各1株。结论加强鼠标日常清洁消毒及监测工作非常重要，应增加清洁消毒频率或更换长效消毒剂，加强病房环境的清洁消毒。

Abstract:

目的探讨金黄色葡萄球菌（SA）克林霉素诱导耐药的发生情况，指导临床用药。方法分析某院2013年1月—2014年12月住院及门诊患者送检的各类临床标本检出的SA。采用KB法进行药敏试验，并以双纸片法（D抑菌圈试验）分析红霉素诱导克林霉素耐药发生情况。结果共检出779株SA，耐甲氧西林金黄色葡萄球菌（MRSA）占74.20%。SA对红霉素耐药、克林霉素敏感有195株，占25.03%，其中D试验阳性147株，克林霉素诱导耐药率75.38%，MRSA和甲氧西林敏感金黄色葡萄球菌（MSSA）D抑菌圈试验阳性率分别为78.62%和61.11%。结论克林霉素诱导耐药率较高，选择克林霉素治疗红霉素耐药SA感染时应谨慎。

Abstract:

脊柱术后植入物感染（spinal implant infection）属于难治性感染，需在系统分析患者基础状况、临床症状、影像学及实验室检查、病原菌类型及病原菌耐药谱的基础上，综合应用内外科治疗手段给予患者个体化治疗，治疗相对困难。治疗方法通常需要在静脉使用抗菌药物的基础上，联合外科清创、持续引流和内固定取出等外科治疗措施。部分患者可能造成内固定失败、局部愈合不良、神经功能障碍、假关节形成，甚至死亡等严重后果。本院于 2014年10月—2015年2月诊治1例脊柱术后植入物感染反复发作患者，现将其诊断和治疗情况总结分析如下。

Abstract:

艰难梭菌（Clostridium  difficile，CD）是梭菌属中的一种专性厌氧、有芽孢、产毒素的革兰阳性粗大杆菌，因其生长营养要求较高，分离培养困难，故得此名。一般栖生在人或动物肠道内，通过粪-口途径引起外源性感染，也可以在使用大量抗菌药物后由肠道栖生的艰难梭菌引起内源性感染。目前，艰难梭菌是唯一能引起医院感染的厌氧菌，也是引起医院感染病原体中唯一能形成芽孢的细菌。约25％的抗生素相关性腹泻 (antibioticassociated diarrhea，AAD)，75％的抗生素相关性肠炎(antibioticassociated colitis，AAC)和近100％的假膜性肠炎(pseudomembranous colitis，PMC)均由此菌引起，统称为艰难梭菌相关性疾病(Clostridium difficileassociated disease，CDAD)。近年来，随着抗菌药物的广泛应用，艰难梭菌耐药性增强，以及高致病菌株出现，导致CDAD发病率及致死率不断增高。目前，国内外已有诸多文献详细介绍了艰难梭菌生物学特性、实验室检测及耐药机制，故本文就艰难梭菌毒力与芽孢予以简要综述。