关于墨西哥Clostridioides difficile感染的多中心研究:探索风景
Daniel De-la-Rosa-Martinez1,2, Diana Vilar-Compte1, Nancy Martínez-Rivera1
1Instituto Nacional de Cancerología, Mexico City, Mexico.
Infection control and hospital epidemiology
|October 21, 2024
概括
艰难菌感染 (CDI) 仍然是墨西哥医院的一个重大问题,与医疗保健相关的病例是最常见的. 公共和私人设施之间的发病率差异凸显了有针对性的监测和干预的必要性.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 公共卫生 公共卫生
背景情况:
- 艰难菌感染 (CDI) 在全球卫生保健机构中构成重大威胁.
- 了解CDI趋势和结果对于有效的感染控制至关重要,特别是在COVID-19等大流行期间.
- 墨西哥医疗保健机构在管理CDI方面面临着独特的挑战,原因是不同的资源和协议.
研究的目的:
- 分析墨西哥医疗机构中Clostridioides difficile感染 (CDI) 趋势和患者结果.
- 调查COVID-19流行病对CDI流行病学和相关死亡率的影响.
- 在墨西哥背景下,确定CDI患者30天全因死亡率的风险因素.
主要方法:
- 从2016年到2022年,在墨西哥的16个公共和私人医疗机构进行了病例系列的观察性研究.
- 从2,356名CDI患者中收集了人口,临床和实验室数据.
- 用多变量逻辑回归分析了30天死亡率的发病率和风险因素.
主要成果:
- 总共有2,356个CDI病例被确定,其中90%与医疗保健相关.
- 常见的并发病包括高血压,糖尿病和癌症,之前经常使用质子抑制剂,类固醇和抗生素.
- 30天死亡率为16% (371名患者),风险因素包括高查尔森得分,类固醇使用,白血病,低albuminemia,性休克和SARS-CoV-2共感染.
- 与医疗保健相关的CDI发病率保持稳定 (4.78例/10,000个患者日),但在公共医院更高.
结论:
- 在墨西哥医疗机构中,常规的流行病学监测和标准化的CDI分类协议是必不可少的.
- 虽然CDI利率与一些欧洲国家相当,但公共部门和私营部门之间存在重大差异.
- 有针对性的干预措施是必要的,以应对墨西哥不同医疗保健机构中CDI负担的变化.
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