由高病毒性菌株引起的Clostridioides difficile感染:一个单一中心的现实研究
Giorgio Tiecco1, Maria Antonia De Francesco2, Angelica Lenzi1
1Department of Clinical and Experimental Sciences, Unit of Infectious and Tropical Diseases, University of Brescia and ASST Spedali Civili Di Brescia, 25123, Brescia, Italy.
概括
超病毒性Clostridioides difficile感染 (CDI) 菌株正在增加,导致死亡率更高. 加强监测和抗菌药物管理对于管理这种与医疗保健相关的感染至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 微生物学 微生物学
背景情况:
- 艰难菌感染 (CDI) 是一个重要的全球医疗保健相关感染.
- 超病毒性C. difficile菌株与疾病严重程度和死亡率的增加有关.
- 了解CDI的流行病学,特别是高病毒性菌株,对于有效管理至关重要.
研究的目的:
- 在意大利的一家三级医院分析CDI的流行病学趋势.
- 为了比较感染超病毒性和非超病毒性C. difficile菌株的患者之间的临床结果.
- 为了确定与高病毒性CDI相关的风险因素.
主要方法:
- 从2015年1月到2023年6月对CDI患者进行的回顾性比较研究.
- 使用GeneXpert测定 (tcdB,tcdA,tcdB,tcdC删除) 识别高病毒性菌株.
- 多变量后勤回归分析以确定风险因素和死亡率预测因素.
主要成果:
- 观察到CDI发病率的统计学意义上的上升趋势.
- 在2021-2022年,超病毒性菌株的显著增加被记录在内.
- 超病毒性CDI与30天死亡率显著增加有关 (18%对5.8%),而先前的抗生素治疗是危险因素.
结论:
- 流行病学数据表明CDI的潜在复苏,可能与COVID-19大流行有关.
- 这些发现强调了需要加强抗微生物药物管理计划的必要性.
- 加强国家监测系统对于监测和管理高病毒性C. difficile菌株至关重要.
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