| 摘要: |
| 目的:探讨益生菌治疗儿童轻度艰难梭菌感染(CDI)的有效性。方法:回顾性分析2023 年6 月至2024 年10 月我院诊治
的71 例轻度CDI 患儿的临床资料,根据治疗方案分为益生菌组和药物组。益生菌组包括VSL#3 组和布拉氏酵母菌及其他益生
菌组。药物组包括甲硝唑组和万古霉素组。结果:共纳入71 例患儿,其中男37 例。年龄≤1 岁24 例;1~ 3 岁29 例;>3 岁
18 例。合并牛奶蛋白过敏49 例。50 例患儿发病前1 个月内有抗菌药物用药史。首次治疗方案分为药物组和益生菌组,药物
治疗32 例,29 例(90. 63%)复发;益生菌治疗39 例,19 例(48. 72%)复发;71 例患儿中有48 例(67. 61%) 复发。根据不同治疗
方案选择,甲硝唑治疗29 例,26 例(89. 66%)复发;万古霉素治疗3 例,3 例(100. 00%) 复发;布拉氏酵母菌及其他益生菌治疗
29 例,16 例(55. 17%)复发;VSL#3 治疗10 例,3 例( 30. 00%) 复发。益生菌组复发率比药物组低,差异有统计学意义( P <
0. 01)。布拉氏酵母菌及其他益生菌组和VSL#3 组复发率均低于甲硝唑组(P<0. 05)。而其他任意两组之间复发率比较差异无
统计学意义(P>0. 05)。复发CDI 患儿中选择VSL#3 治疗26 例,4 周缓解率80. 77%。结论:CDI 患儿初始治疗方案中益生菌比
药物治疗的复发率低,益生菌可以作为儿童轻度CDI 治疗的一种选择。 |
| 关键词: 儿童 艰难梭菌感染 甲硝唑 万古霉素 益生菌 布拉氏酵母菌 复发 |
| DOI：doi:10.13407/j.cnki.jpp.1672-108X.2025.10.014 |
|
| 基金项目:北京市卫生与健康科技成果和适宜技术推广项目,编号TG-2017-41;白求恩·儿科中青年医生能力提升计划暨儿童临床营养研
究专项资助项目,编号2022E17-B18。 |
|
| Evaluation on Efficacy of Different Treatment Regimens for Mild Clostridium Difficile Infection in Children |
| Wang Jian, Yin Xiaomei, Du Yanyan, Song Lin, Li Ningning, Xu Xiwei |
| ((Beijing Tsinghua Changgung Hospital,
Tsinghua University, Beijing 102218, China)) |
| Abstract: |
| Objective: To probe into the efficacy of different treatment regimens for mild Clostridium difficile infection (CDI) in
children. Methods: Clinical data of 71 children with mild CDI in our hospital from Jun. 2023 to Oct. 2024 were retrospectively
analyzed. All initial CDI patients were divided into medicine group and probiotics group according to different treatment regimens. The
probiotics group included VSL#3 group, Saccharomyces boulardii and other probiotics group. The medicine group included metronidazole
group and vancomycin group. Results: A total of 71 children, including 37 males, were enrolled in the study. There were 24 patients
aged ≤1 year, 29 patients aged from 1 to 3 years, and 18 patients aged >3 years. There were 49 cases of children with milk protein
allergy, and 50 children had a history of antibiotic exposure within one month before the onset of the disease. The first treatment regimen
was divided into medicine group and probiotics group, 32 patients were treated with drugs, 29 patients (90. 63%) had recurrence; 39
patients were given probiotics, 19 patients (48. 72%) had recurrence. Among the 71 children, 48 cases (67. 61%) had recurrence.
Depending on the different treatment regimens, metronidazole was used in 29 cases, with 26 cases (89. 66%) showing recurrence;
vancomycin was used in 3 cases, and 3 cases (100. 00%) had recurrence; Saccharomyces boulardii and other probiotics were used in 29
cases, with 16 cases (55. 17%) showing recurrence; VSL#3 was used in 10 cases, and 3 cases (30. 00%) had recurrence. The
recurrence rate in probiotics group was lower than that in medicine group, the difference was statistically significant (P<0. 01). The
recurrence rates of S. boulardii and other probiotics group and VSL#3 group were lower than those of metronidazole group (P<0. 05).
However, there was no statistically significant difference in recurrence rates between any other two groups (P>0. 05). Of the recovery
CDI patients, 26 children were treated with VSL#3 and the effective rate was 80. 77% with the 4 weeks treatment. Conclusion: In the
initial treatment regimen for children with CDI, probiotics have a lower recurrence rate than drug therapy. Probiotics can be used as an
option for the treatment of mild CDI in children. |
| Key words: children Clostridium difficile infection metronidazole vancomycin probiotics Saccharomyces boulardii recurrence |
