在患有毒性Clostridioides difficile菌群的患者中发展困难菌群感染的危险因素
Josh Clement1,2, Gauri Barlingay3, Sindhu Addepalli4
1Department of Pharmacy, University of California Davis Health, Sacramento, CA, USA.
Infection control and hospital epidemiology
|February 24, 2025
概括
无症状的患者被毒性Clostridioides difficile殖民,可能会患上C. difficile感染 (CDI). 进入医院发作的CDI的主要风险因素包括先前的抗生素暴露和某些医疗条件.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 临床医学 临床医学
背景情况:
- 无症状的殖民化与毒性Clostridioides difficile构成发展C. difficile感染 (CDI) 的风险.
- 了解从殖民到住院CDI (HO-CDI) 的进展风险因素对于预防至关重要.
研究的目的:
- 估计在患有毒性C. difficile菌落的患者中HO-CDI的发病率.
- 在被殖民的个体中识别与 HO-CDI 的进展相关的风险因素.
主要方法:
- 一项嵌套病例控制研究使用了2017-2020年的数据进行.
- 纳入了成年患者,他们被毒性C. difficile定居,通过PCR在入院直肠拭子上确定.
- 用双变量和多变量考克斯回归分析了HO-CDI进展的风险因素.
主要成果:
- 在殖民患者中,HO-CDI的估计发病率为4.2% (321人中有69人).
- 进展的重大风险因素包括肝硬化,ICU入院,恶性瘤和最近住院.
- 此前在三个月内接触过抗生素和接受有风险的抗生素也被确定为显著的危险因素.
结论:
- 从无症状殖民到HO-CDI的进展是一个值得关注的问题.
- 识别高风险人群,如肝硬化,ICU入院,恶性瘤或最近接触抗生素的人群至关重要.
- 建议加强监测和有针对性的预防策略,以减轻高危殖民患者的HO-CDI.
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