在澳大利亚的一个地区医院中,Clostridioides difficile感染和抗生素处方:一个病例控制研究
Sarah Elizabeth Alland1,2, Bianca Mills3, Michelle Bolte3
1National Centre for Epidemiology and Population Health, Australian National University, Canberra, ACT, Australia.
抗生素处方实践,包括特定的和青素,与医院获得的Clostridioides difficile感染 (CDI) 的增加有关. 遵守抗生素指南对于减少CDI率的抗菌药物管理计划至关重要.
科学领域:
- 传染性疾病 传染性疾病
- 医院流行病学 医院流行病学
- 抗微生物药物管理委员会
背景情况:
- 2021年,澳大利亚医院的Clostridioides difficile感染 (CDI) 病例数量有所增加.
- 这项研究调查了新南威尔士州一家区域医院的CDI趋势.
- 目的是将抗生素处方与医院获得的CDI联系起来,以告知抗菌药物管理 (AMS).
研究的目的:
- 调查抗生素处方实践与医院获得的CDI之间的联系.
- 为加强抗微生物管理 (AMS) 计划提供证据.
- 确定与增加CDI风险相关的特定抗生素类.
主要方法:
- 追溯病例控制研究 (2018年7月 - 2022年6月).
- 在医院获得的70例CDI病例与住院日期和年龄的对照 (1:2比) 相匹配.
- 多变量分析以确定风险因素,并比较病例与对照中的抗生素处方.
主要成果:
- 第三代,第四代或第五代头素 (aOR 3.82) 和广泛/扩展的广谱青素 (aOR 5.79) 独立地与CDI相关.
- 增加的并发症复杂性 (aOR 1.22) 也与CDI有关.
- 不适当的抗生素处方 (OR 5.68) 和不遵守指南 (OR 5.01) 与接受抗生素的患者的CDI有关.
结论:
- 抗生素处方实践与医院获得的CDI有显著的相关性.
- 遵守抗生素处方指南对于预防CDI至关重要.
- 这些发现支持实施和加强AMS计划以减轻CDI.
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