Changes of intestinal microbiota in patients with digestive system diseases with Clostridium difficile infection
OBJECTIVE To evaluate the changes of intestinal microflora in patients with digestive diseases infected with Clostridium difficile(CDI),in order to provide reference for clinical diagnosis and treatment.METHODS Data of 189 patients with hospital-acquired diarrhea admitted to Dongguan People's Hospital from Jun 2020 to Jun 2023 were included and divided into two groups according to the detection results of C.difficile-positive and-negative at the ratio of 1∶2(63 cases:126 cases).The isolates of C.difficile was detected and cultured for pathogen identification.And the drug susceptibility was detected.The correlation between genotypes and the clini-cal results was analyzed.Real-time quantitative polymerase chain reaction(PCR)was used to detect bacterial tar-gets in the gut microbiome.RESULTS Totally 51 strains of C.difficile were detected in 189 patients with diges-tive diseases,of which 23 were virus-producing strains.18.3％(22/120)of skin and environmental samples showed positive results for C.difficile colonization.Low concentrations of metronidazole and vancomycin[mini-mum inhibitory concentration(MIC)90,0.5 and 1.2 mg/L]inhibited all toxogenic C.difficile.In addition,these strains showed the highest rates of resistance to moxifloxacin and clindamycin(MIC 90,0.5 and 1.6 mg/L).There were significant differences in bacterial species between digestive disease group and healthy control group(P＜0.05).In addition to bifidobacterium and enterococcus,there were also differences in bacterial species be-tween CDI digestive disease group and non-CDI digestive disease group(P＜0.05).The load of firmicutes in CDI digestive disease group was higher than that in non-CDI digestive disease group(P＜0.05),while that in non-CDI digestive disease group was significantly higher than that in healthy control group(P＜0.05).In terms of bacte-roidetes loading,the healthy control group was＞non-CDI digestive disease group＞CDI digestive disease group,and the differences were statistically significant(P＜0.05).CONCLUSION Despite appropriate infection control strategies in the digestive disease intensive care unit,CDI remains prevalent in patients with severe diges-tive disease.Ultimately,the overgrowth of Vibrio mucosus and the reduced abundance of Staphylococcus prevotelli in patients with CDI digestive disease may be potential microbiome biomarkers in patients with digestive disease.
Clostridium difficile infectionIntestinal floraStaphylococcus prevoi aureusDigestive system dis-easesToxigenic Clostridium difficile
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