抗生素的使用和医院发病的克洛斯特里迪奥伊德难以感染的风险.
Mayan Gilboa1,2,3, Gili Regev-Yochay1,2,3, Eyal Meltzer1,4
1Faculty of Medical and Health Sciences, Tel-Aviv University, Ramat-Aviv, Tel-Aviv, Israel.
难以携带 Clostridioides 的携带者面临着显著更高的医院发病感染风险. 抗生素的使用增加了非携带者,但不是携带者的感染危险,这表明需要有针对性的预防策略.
科学领域:
- 传染性疾病 传染性疾病
- 流行病学 流行病学
- 医疗保健管理的管理
背景情况:
- 困难菌是医疗保健相关感染的主要原因之一.
- 了解C. difficile携带,抗生素使用和感染风险之间的相互作用对于有效的预防策略至关重要.
研究的目的:
- 评估无症状携带者与非携带者的C. difficile感染 (CDI) 风险.
- 为了确定抗生素暴露是否在携带者和非携带者之间不同地影响CDI危险.
主要方法:
- 追溯队列研究分析了谢巴医疗中心的住院病例 (2017年6月-2023年6月).
- 包括在入院时查C. difficile的成年患者,不包括那些有活跃CDI的患者.
- 评估了抗生素暴露作为时间变量的变量和CDI发展作为主要结果.
主要成果:
- 在入院时呈阳性C. difficile查与CDI的危险增加了27.5倍.
- 抗生素暴露增加了CDI的危险性 (HR 1.98),而皮佩拉西林-塔扎巴克坦显示出最高的风险 (HR 2.18).
- 在携带者中,抗生素暴露并没有显著增加CDI危险 (HR 1.07).
结论:
- 无症状的C. difficile携带者具有显著增加的入院CDI的基线风险.
- 抗生素管理可能会减轻非载体的CDI风险,但由于载体的基线风险很高,需要对载体进行额外的干预.
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