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在一个大型医院系统中,从聚合酶连锁反应转换到两步Clostridioides difficile测试的影响

Sapana R Gupta¹, Tyler M Selig², Kathryn Evey¹

¹Department of Medicine, Brown University Health, Providence, RI, USA.

Antimicrobial stewardship & healthcare epidemiology : ASHE

|November 27, 2025

概括

在医院中,针对Clostridioides difficile感染 (CDI) 的新两步测试策略没有损害患者的结果. 这种方法适度减少了CDI不必要的抗生素使用,表明它是一种安全有效的测试方法.

科学领域:

传染性疾病传染性疾病
临床微生物学临床微生物学
医疗卫生流行病学医疗卫生流行病学

背景情况:

艰难闭膜炎感染 (CDI) 是导致医院获得的腹的主要原因.
目前的诊断方法包括酶免疫测试 (EIA) 和聚合酶链反应 (PCR).
这项研究评估了从仅PCR转向两步CDI测试算法的转变.

研究的目的:

评估实施两步CDI测试算法的影响.
为了比较仅PCR和两步测试队列之间的患者结果.
评估对抗CDI抗生素利用的影响.

主要方法:

对2,173名成年住院患者进行了回顾性队列研究.
仅PCR测试 (2019年6月-2021年5月) 与两步测试 (2021年6月-2023年5月) 的比较.
分析并发症,包括死亡,切除术,ICU转移和30天再入院,按患者风险组分层.

主要成果:

两步算法显示,对患者并发症没有显著的负面影响.
在中度风险组中,重症监护室 (ICU) 转移率 (5%) 和再入院率 (7%) 显著下降.
根据两步方案,15%的EIA阴性患者停止服用抗CDI抗生素,中度风险患者与严重风险患者相比,停止治疗的可能性较低.

结论:

两步CDI测试算法对住院患者是安全的.
这种方法可以导致抗CDI抗生素使用量略有下降.
这些发现支持采用CDI诊断的两步测试策略.

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