摘要: 目的 掌握医院艰难梭菌近几年的感染状况，为医院感染监测和防控提供现实依据。方法 收集院内2014年1月至2014年12月106例住院腹泻患者粪便标本为前期组，同时选择2016年1月至2016年12月90例住院腹泻患者粪便标本为后期组，采用艰难梭菌显色平板筛选可疑菌落，通过镜检和质谱仪进行鉴定；同时对粪便标本通过酶免疫分析方法检测毒素A、B；对于培养阳性的菌株采用PCR扩增毒素A、B基因片段；比较两个时期艰难梭菌感染情况以及不同方法检出率的差异。结果 两个检测方法厌氧培养及酶免疫分析监测艰难梭菌感染阳性率无统计学差异。同一时期不同方法阳性率比较无统计学意义，另外PCR扩增结果除后期组2株阴性外均产毒素A、B。结论 两个时期艰难梭菌感染率均较高，说明我院艰难梭菌感染形势严峻，应高度关注，及时监测，防止传播和流行。

Abstract: Objective To understand the infection status of Clostridium difficile in recent years, and provide a practical basis for nosocomial surveillance, prevention and control. Methods The collected 106 fecal specimens of hospitalized patients with diarrhea from January 2014 to December 2014 was the former group, and 90 fecal specimens of hospitalized patients with diarrhea from January 2016 to December 2016 was the latter group.And the suspicious colonies were screened in Clostridium difficile color plate and identified by microscopy and mass spectrometry.Toxins A and B in fecal specimens were detected by enzyme immunoassay assay.The gene fragments of toxin A and toxin B were amplified by PCR for cultured positive strains.The infection status of clostridium difficile between two periods and the detection rates of different methods were compared. Results There were no significant differences of the positive rates with anaerobic culture and enzyme immunoassay and the different methods at the same time.Besides, except two strains of the later group toxins A and B were positive by PCR amplification. Conclusion The positive rates of clostridium difficile with different methods have no obvious differences.The infection rates of clostridium difficile during two periods are relatively higher, and the detection rates are essentially in agreement.This indicates that the situation of clostridium difficile infection is severe in our hospital, which should be paid close attention and monitored in time to prevent its spread and epidemic.