查和针对性预防Clostridioides困难感染:停止-CDI.
Mathew J Ziegler1, Judith Anesi1, Pam Tolomeo2
1Division of Infectious Diseases, Department of Medicine, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania USA; Department of Biostatistics, Epidemiology, and Informatics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania USA; Center for Clinical Epidemiology and Biostatistics, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania USA.
在免疫功能低下的患者中,预防性肠道万科米辛显著降低了医院发作的Clostridioides difficile感染 (HO-CDI). 这种干预措施还减少了C. difficile的症状和住院时间.
科学领域:
- 传染性疾病 传染性疾病
- 在瘤学瘤学.
- 移植医学 移植医学
背景情况:
- 接受瘤治疗或实体器官移植的免疫功能低下患者面临着高风险的医院发病的Clostridioides difficile感染 (HO-CDI).
- 需要有效的策略来减轻这些脆弱患者群体的HO-CDI风险.
研究的目的:
- 评估预防性肠道万科米辛干预对降低HO-CDI率的影响.
- 评估干预对C. difficile殖民的影响以及高风险住院患者的相关临床结果.
主要方法:
- 查和向预防 (STOP) 干预措施涉及查高风险患者 (移植,CAR-T,白血病) 进行C. difficile殖民.
- 殖民患者接受了预防性肠道万科米辛和接触隔离.
- 结果与干预实施前两年的历史控制进行了比较.
主要成果:
- 与加权对照组 (OR 0.15) 相比,干预组显示HO-CDI的几率明显较低 (0.88%对5.6%).
- 观察到90天CDI,便量和停留时间的显著减少.
- 在VRE感染或死亡率方面没有发现显著差异.
结论:
- 在免疫功能低下的患者中,STOP干预有效降低了HO-CDI.
- 预防性肠道万科米辛是一种可行的策略,可以降低高风险队列中C. difficile相关的发病率和医疗保健资源利用率.
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