在患有炎症性肠病的患者中,抗生素的使用和Clostridioides difficile感染的风险
Alexis Bejcek1, Anupama Ancha2, Megan Lewis1
1Division of Gastroenterology, Department of Medicine, Baylor Scott & White Medical Center, Temple, Texas, USA.
门诊抗生素使用增加了炎症性肠病 (IBD) 患者的Clostridioides difficile感染 (CDI) 风险. 克林达米辛和甲尼达特别与这一群体中较高的CDI率有关.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 药理学 药理学是指药理学的学科.
背景情况:
- 炎症性肠病 (IBD) 患者面临着更高的Clostridioides difficile感染 (CDI) 风险.
- 抗生素使用加剧了IBD中CDI风险,但在先前的研究中,这一群体的代表性不足.
- 这项研究调查了IBD患者与门诊抗生素处方相关的CDI发病率.
研究的目的:
- 评估门诊抗生素使用与炎症性肠病 (IBD) 患者中Clostridioides difficile感染 (CDI) 的发生率之间的关联.
- 确定在IBD人群中增加CDI风险的特定抗生素类别.
主要方法:
- 一项回顾性队列研究比较了在2014-2020年期间有 (n=6694) 和没有 (n=6025) 门诊抗生素处方的IBD患者的CDI率.
- 在九种抗生素类别中分析了CDI发病率:青素,头素,硫胺,四环素,宏化物,醇,克林达米辛,甲尼达和酸黄.
主要成果:
- 总体CDI风险低 (0.7%),但在暴露于抗生素的患者中显著增加 (0.9%对0.5%,P=0.005).
- 吸烟史与CDI风险增加正相关.
- 克林达米辛 (OR=4.7) 和美特罗尼达 (OR=3.6) 与IBD患者的CDI风险增加有显著关联.
结论:
- 门诊临达米辛和甲尼达的处方与IBD患者的CDI风险的统计学上显著增加有关.
- 虽然克林达米辛与CDI的关联是已知的,但与甲尼达的联系是这项研究中的新发现.
- 这些发现突出了IBD人口中CDI的特定抗生素风险,为临床实践提供了信息.
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