Argamany Jacqueline R, Aitken Samuel L, Lee Grace C, Boyd Natalie K, Reveles Kelly R
Pharmacotherapy Division, College of Pharmacy, University of Texas at Austin, Austin, TX; Pharmacotherapy Education and Research Center, School of Medicine, University of Texas Health Science Center at San Antonio, San Antonio, TX.
Division of Pharmacy, University of Texas MD Anderson Cancer Center, Houston, TX.
Am J Infect Control. 2015 May 1;43(5):435-40. doi: 10.1016/j.ajic.2014.11.018.
This study identified national regional and seasonal variations in Clostridium difficile infection (CDI) incidence and mortality among hospitalized patients in the United States over a 10-year period.
This was a retrospective cohort study of the U.S. National Hospital Discharge Survey from 2001-2010. Eligible cases had an ICD-9-CM discharge diagnosis code for CDI (008.45). Data weights were used to derive national estimates. CDI incidence and mortality were presented descriptively. Regions were as defined by the U.S. Census Bureau. Seasons included the following: winter (December-February), spring (March-May), summer (June-August), and fall (September-November).
These data represent 2.3 million CDI discharges. Overall, CDI incidence was highest in the Northeast (8.0 CDIs/1,000 discharges) and spring (6.2 CDIs/1,000 discharges). CDI incidence was lowest in the West (4.8 CDIs/1,000 discharges) and fall (5.6 CDIs/1,000 discharges). Peak CDI incidence among children occurred in the West (1.7 CDI/1,000 discharges) and winter (1.5 CDI/1,000 discharges). Mortality among all CDI patients was highest in the Midwest (7.3%) and during the winter (7.9%).
The region and season with the highest CDI incidence rates among patients hospitalized in U.S. hospitals were the Northeast and spring, respectively. The highest CDI mortality rates were seen in the Midwest and winter. Children exhibited different regional and seasonal CDI variations compared with adults and older adults.
本研究确定了美国住院患者艰难梭菌感染（CDI）发病率和死亡率在10年期间的全国、地区和季节变化。
这是一项对2001年至2010年美国国家医院出院调查的回顾性队列研究。符合条件的病例有CDI的ICD-9-CM出院诊断代码（008.45）。数据权重用于得出全国估计值。对CDI发病率和死亡率进行了描述性呈现。地区由美国人口普查局定义。季节包括：冬季（12月至2月）、春季（3月至5月）、夏季（6月至8月）和秋季（9月至11月）。
这些数据代表230万例CDI出院病例。总体而言，CDI发病率在东北部最高（每1000例出院中有8.0例CDI），在春季最高（每1000例出院中有6.2例CDI）。CDI发病率在西部最低（每1000例出院中有4.8例CDI），在秋季最低（每1000例出院中有5.6例CDI）。儿童CDI发病率高峰出现在西部（每1000例出院中有1.7例CDI）和冬季（每1000例出院中有1.5例CDI）。所有CDI患者的死亡率在中西部最高（7.3%），在冬季最高（7.9%）。
在美国医院住院患者中，CDI发病率最高的地区和季节分别是东北部和春季。CDI死亡率最高的地区是中西部，季节是冬季。与成年人和老年人相比，儿童表现出不同的地区和季节CDI变化。
