对于非C. difficile抗生素患者的Clostridioides difficile感染的二次预防:一项回顾性队列研究
Ronza Najjar-Debbiny1, Ofra Barnett-Griness2, Anat Arbel3
1Infection Control and Prevention Unit, Lady Davis Carmel Medical Center, Haifa, Israel; Ruth and Bruce Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
二次抗生素预防可以减少复发的Clostridioides difficile感染 (CDI) 在没有严重初始发作的患者. 这种方法有望防止CDI复发,但需要进一步的研究来确认.
科学领域:
- 传染性疾病 传染性疾病
- 临床微生物学 临床微生物学
- 公共卫生 公共卫生
背景情况:
- 反复复发的Clostridioides difficile感染 (CDI) 带来了重大的医疗保健挑战和发病率.
- 目前使用预防性口服抗生素预防CDI复发的策略缺乏最终共识.
研究的目的:
- 调查二次性CDI抗生素预防与CDI复发风险之间的关联.
- 检查CDI预防对4周和8周后CDI指数所有原因死亡率的影响.
- 评估最初的CDI事件的严重程度是否会改变预防对复发的影响.
主要方法:
- 使用来自以色列最大的医疗保健提供者的数据 (2018年2月至2022年12月) 的回顾性队列研究.
- 确定了第一个CDI发作的成年患者,他们在2-8周内接受非CDI抗生素.
- 多变量Cox比例危险回归模型分析了二次预防与CDI复发和死亡率的关联,按CDI严重程度指数分层.
主要成果:
- 总共有434名患者被纳入;107人接受了CDI抗生素预防.
- CDI抗生素预防与CDI复发风险降低相关 (aHR为0.51).
- 保护作用对于非严重的CDI (aHR 0.163) 是显著的,但对于严重的CDI (aHR 1.242) 却没有显著的保护作用,严重程度有显著的相互作用 (P=0.0182).
- 在预防和4-8周全因死亡率之间没有发现显著的关联.
结论:
- 用CDI抗生素进行二次预防可能会降低之前非严重的CDI患者的复发风险.
- 似乎CDI预防的有效性取决于最初发作的严重程度.
- 需要进一步的研究来验证这些发现,并为临床指南提供信息.
更多相关视频
09:12A Protein Microarray Assay for Serological Determination of Antigen-specific Antibody Responses Following Clostridium difficile Infection
Published on: June 15, 2018
06:51Cefoperazone-treated Mouse Model of Clinically-relevant Clostridium difficile Strain R20291
Published on: December 10, 2016
相关概念视频
Transmission-based Precautions I: Contact, Enteric, and Droplets
Contact Precautions:
Contact precautions are the measures taken to prevent the transmission of infectious agents, especially epidemiologically important microorganisms such as MRSA or influenza, primarily transmitted through direct or indirect contact with an...
Transmission-based Precautions II: Airborne and Protective Environment
Airborne precautions:
Use airborne precautions when treating patients known or suspected to have diseases that spread through the air—for example, tuberculosis or measles. These organisms are present in smaller droplets expelled by an infected person and...
Standard Precaution
Hand hygiene is the most crucial means to prevent the transmission of disease. Employers are legally required to provide their workers with personal protective equipment (PPE) to minimize exposure or contact with...
Drugs for Treatment of Constipation-Predominant IBS
Antibiotic Selection
Drugs for Treatment of Diarrhea-Predominant IBS
Two specific drugs used in the treatment are alosetron (Lotronex) and eluxadoline (Viberzi). Alosetron, a 5-HT3 antagonist, works by slowing the movement of stools in the gut, reducing bowel...
