密集护理病房中Clostridioides difficile感染的临床特征和结果:一个KASID多中心研究
J E Baek1, I H Choi1, Y W Cho1
1Division of Gastroenterology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
The Journal of hospital infection
|July 14, 2023
概括
在重症监护病房 (ICU) 中,困难菌感染 (CDI) 不成比例地影响高风险患者,导致治愈率较低和死亡率较高. 需要改进预测评分系统,以便在CDI患者中获得更好的临床结果.
科学领域:
- 传染性疾病 传染性疾病
- 关键护理医学 关键护理医学
- 流行病学 流行病学
背景情况:
- 困难菌感染 (CDI) 构成了重大的临床和经济挑战.
- 关于亚太地区重症监护病房 (ICU) 中的CDI存在有限的数据.
研究的目的:
- 调查韩国ICU中CDI患者的临床特征,治疗反应和死亡率.
- 在这个患者群体中确定与治疗失败和死亡率相关的因素.
主要方法:
- 在韩国 (2017年1月 - 2021年5月) 住院于ICU的191名CDI患者的回顾性分析.
- 利用后退一步的多重后勤回归来确定治疗反应和死亡率的预测因素.
- 使用查尔森并发症指数,APACHE II,ATLAS和SOFA分数评估患者的严重程度.
主要成果:
- 30.4%的患者免疫受损;30.4%的患者患有严重的CDI,20.9%的患者患有 fulminant CDI.
- 10天治疗反应率为59.7%,整体8周死亡率为41.4%.
- 爆发性CDI和较高的SOFA得分与治疗失败有关. 高APACHE II和SOFA分数预测死亡率增加.
结论:
- 患有CDI的高风险ICU患者经历了较差的结果,包括较高的死亡率和较低的治愈率.
- 目前的评分系统 (APACHE II,SOFA) 与在ICU获得的CDI中的死亡率有关.
- 需要进一步的研究来开发改进的预测评分系统,以便更好地进行CDI的临床管理.
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