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他汀类药物对住院患者艰难梭菌感染结局的影响。

The effect of statins on the outcome of Clostridium difficile infection in hospitalized patients.

作者信息

Atamna A, Yahav D, Eliakim-Raz N, Goldberg E, Ben-Zvi H, Barsheshet A, Elis A, Bishara J

机构信息

Internal Medicine Department "C", Rabin Medical Center, Beilinson Hospital, 49100, Petah-Tikva, Israel.

Infectious Diseases Unit, Rabin Medical Center, Beilinson Hospital, Petah-Tikva, Israel.

出版信息

Eur J Clin Microbiol Infect Dis. 2016 May;35(5):779-84. doi: 10.1007/s10096-016-2597-9. Epub 2016 Feb 10.

DOI:10.1007/s10096-016-2597-9
PMID:26864041
Abstract

UNLABELLED

Several studies have shown an association between exposure to statins and favorable clinical outcomes for various types of infections. We aimed to assess the impact of statin use on mortality, disease severity and complications among hospitalized patients with Clostridium difficile infection (CDI). Data were analyzed from a retrospectively collected database of 499 patients diagnosed with CDI during 2009-2014. We compared infection outcomes between 178 statin (36 %) users and 321 (64 %) non-users. On multivariate analysis, we found that statin use did not have a significant impact on 30-day mortality (OR = 1.54; 95 % CI, 0.85-2.79; p = 0.15) or any significant effect on CDI severity and complication. Concomitant statin use has no significant impact on short-term mortality or effect on CDI severity and complications among hospitalized patients with CDI. However, patients in the statin group were older and had higher Charlson score compared with the non-statin group. Whether these factors affected a possible impact of statins on the disease course remains to be investigated.

KEY MESSAGES

• Clostridium difficile is the most common cause of infectious nosocomial diarrhea among hospitalized adult patients in the developed countries. • There is an increasing morbidity and mortality of CDI patients due to the emergence of new strains of high virulence. • Recent studies demonstrated that prior statin use has protective and ameliorating effects on morbidity and mortality among CDI patients. • Our study showed that concomitant statin use has no significant impact on short-term mortality, CDI severity and its complications.

摘要

未标注

多项研究表明,使用他汀类药物与各类感染的良好临床结局之间存在关联。我们旨在评估他汀类药物的使用对艰难梭菌感染(CDI)住院患者死亡率、疾病严重程度及并发症的影响。对2009年至2014年期间回顾性收集的499例诊断为CDI的患者数据库进行数据分析。我们比较了178例(36%)他汀类药物使用者和321例(64%)非使用者的感染结局。多因素分析显示,他汀类药物的使用对30天死亡率无显著影响(OR = 1.54;95% CI,0.85 - 2.79;p = 0.15),对CDI严重程度及并发症也无显著影响。在CDI住院患者中,同时使用他汀类药物对短期死亡率无显著影响,对CDI严重程度及并发症也无影响。然而,与非他汀类药物组相比,他汀类药物组患者年龄更大,查尔森评分更高。这些因素是否影响他汀类药物对疾病进程的可能影响仍有待研究。

关键信息

• 艰难梭菌是发达国家住院成年患者感染性医院腹泻最常见的病因。

• 由于高毒力新菌株的出现,CDI患者的发病率和死亡率不断上升。

• 近期研究表明,既往使用他汀类药物对CDI患者的发病率和死亡率有保护和改善作用。

• 我们的研究表明,同时使用他汀类药物对短期死亡率、CDI严重程度及其并发症无显著影响。

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本文引用的文献

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The Addition of Intravenous Metronidazole to Oral Vancomycin is Associated With Improved Mortality in Critically Ill Patients With Clostridium difficile Infection.静脉注射甲硝唑联合口服万古霉素可改善艰难梭菌感染的危重症患者的死亡率。
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Statin Use and the Point Prevalence of Antibiotics in Ambulatory Patients with Diabetes in the National Health and Nutrition Examination Survey (NHANES) 2003-2012.2003 - 2012年美国国家健康与营养检查调查(NHANES)中糖尿病门诊患者他汀类药物的使用情况及抗生素的时点患病率
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A possible association between statin use and improved Clostridioides difficile infection mortality in veterans.他汀类药物的使用与退伍军人中艰难梭菌感染死亡率的降低有关。
PLoS One. 2019 May 28;14(5):e0217423. doi: 10.1371/journal.pone.0217423. eCollection 2019.
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Meta-analysis comparing the effects of statins on the risk of diarrhea.比较他汀类药物对腹泻风险影响的荟萃分析。
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