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[艰难梭菌感染的发病率及临床特征;单中心研究]

[The incidence and clinical features of Clostridium difficile infection; single center study].

作者信息

Lee Jin Ho, Lee Su-Yeon, Kim You Sun, Park Sun-Wook, Park Sung Won, Jo So Young, Ryu Soo Hyung, Lee Jung Hwan, Moon Jeong Seop, Whang Dong Hee, Shin Bo Moon

机构信息

Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Jung-gu, Seoul, Korea.

出版信息

Korean J Gastroenterol. 2010 Mar;55(3):175-82. doi: 10.4166/kjg.2010.55.3.175.

Abstract

BACKGROUND/AIMS: Clostridium difficile is the predominant cause of nosocomial diarrhea. Recently, the incidence of Clostridium difficile infection (CDI) increases in Europe and North America. A retrospective study was performed to evaluate the change of incidence and clinical features of CDI in Korea.

METHODS

From January 2003 to December 2008, inpatients diagnosed with CDI in Seoul Paik hospital were enrolled. The diagnosis of CDI was made when patients complained diarrhea with any positive results in C. difficile toxin assay, stool culture, or endoscopy. The incidence, recurrence rate, and clinical features were compared between early period (2003-2005) and late period (2006-2008).

RESULTS

The incidence of CDI was 21.73 cases per 10,000 admitted patients in early period group, and significantly increased to 71.71 cases per 10,000 admitted patients in late period group (p < 0.01). The hospital stay duration at the time of CDI diagnosis was shorter in late period group. Cephalosporin had the highest ratio as the causative antibiotics of CDI. However, there was no difference in recurrence rate between early and late period groups. Recurrence associated clinical factor was serum albumin level.

CONCLUSIONS

The incidence of CDI showed increasing tendency during recent 6 years. The awareness of increasing disease burden is the first step in control of CDI.

摘要

背景/目的:艰难梭菌是医院内腹泻的主要病因。近来,艰难梭菌感染(CDI)在欧洲和北美的发病率有所上升。本研究进行了一项回顾性研究,以评估韩国CDI发病率及临床特征的变化。

方法

纳入2003年1月至2008年12月在首尔白医院诊断为CDI的住院患者。当患者出现腹泻且艰难梭菌毒素检测、粪便培养或内镜检查有任何阳性结果时,诊断为CDI。比较早期(2003 - 2005年)和晚期(2006 - 2008年)的发病率、复发率及临床特征。

结果

早期组每10000例入院患者中CDI发病率为21.73例,晚期组显著增至每10000例入院患者71.71例(p < 0.01)。晚期组CDI诊断时的住院时间较短。头孢菌素作为CDI致病抗生素的比例最高。然而,早期和晚期组的复发率无差异。复发相关的临床因素是血清白蛋白水平。

结论

近6年来CDI发病率呈上升趋势。认识到疾病负担增加是控制CDI的第一步。

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