通过Clostridium difficile的主要无症状定居和随后腹的风险降低
J K Shim1, S Johnson, M H Samore
1Department of Medicine, Veterans Affairs Chicago Healthcare System, Northwestern University Medical School, Chicago, Illinois 60611, USA.
Lancet (London, England)
|March 21, 1998
概括
主要无症状的Clostridium difficile定居与发展Clostridium-difficile相关腹 (CDAD) 的风险降低有关. 这种保护作用在有毒性和非有毒性C. difficile菌株中都被观察到.
科学领域:
- 微生物学 微生物学
- 传染性疾病 传染性疾病
- 流行病学 流行病学
背景情况:
- 克洛斯特里困难相关腹 (CDAD) 是一个重要的医疗相关感染.
- 在CDAD的发展中无症状的Clostridium difficile殖民的作用仍然不清楚.
- 抗生素暴露是CDAD的主要风险因素.
研究的目的:
- 调查是否在没有症状的C. difficile殖民的患者 (主要无症状携带者) 与培养负的患者相比,患有CDAD的风险不同.
- 确定无症状殖民是否会影响CDAD的风险,特别是在使用抗生素的情况下.
主要方法:
- 一项对四项涉及810名住院患者的纵向研究的元分析.
- 预期的直肠片培养每周至少连续两周进行一次.
- 用随机效应模型计算和聚合了被殖民和未被殖民患者之间的CDAD风险差异.
主要成果:
- 被C. difficile定居的患者患CDAD的风险显著降低 (综合风险差异 -2.3%,p=0.021).
- 在接受抗生素的患者中也观察到这种保护作用 (综合风险差异 -3.2%,p=0.024).
- 无症状的殖民包括毒性菌株,非毒性菌株和混合菌株,毒性菌株也在患有CDAD的患者的便中发现.
结论:
- 首次无症状的C. difficile殖民与患CDAD的风险降低有关.
- 这种降低风险的机制尚不清楚,但似乎适用于毒性和非毒性C. difficile菌株.
- 这些发现表明,殖民,菌株类型和疾病发展之间存在复杂的相互作用.
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