西班牙重症患者艰难梭菌感染的流行病学及危险因素：PROCRID研究
Epidemiology and risk factors for Clostridium difficile infection in critically ill patients in Spain: The PROCRID study.
作者信息
Gutiérrez-Pizarraya Antonio, Martín-Villén Luis, Alcalá-Hernández Luis, Marín Arriaza Mercedes, Balandín-Moreno Bárbara, Aragón-González César, Ferreres-Franco José, Chiveli Monleón Miguel Ángel, Anguita-Alonso Paloma, Bouza-Santiago Emilio, Garnacho-Montero José
机构信息
Instituto de Biomedicina de Sevilla, IBIS/Hospitales Universitarios Virgen Macarena - Virgen del Rocío/CSIC/Universidad de Sevilla, Sevilla, Spain.
Unidad Clínica de Cuidados Intensivos, Hospital Virgen del Rocío, Sevilla, Spain.
出版信息
Enferm Infecc Microbiol Clin (Engl Ed). 2018 Apr;36(4):218-221. doi: 10.1016/j.eimc.2017.01.007. Epub 2017 Mar 6.
INTRODUCTION
Our objectives were to describe the incidence, clinical characteristics, and risk factors for Clostridium difficile infection (CDI) in critically ill patients and to determine C. difficile PCR-ribotypes.
METHODS
Prospective, observational study in 26 Spanish ICUs. Patients with diarrhea meeting ESCMID criteria for CDI were included. Molecular characterization of isolates was performed using PCR ribotyping.
RESULTS
Of 4258 patients admitted to the ICUs, 190 (4.5%) developed diarrhea. Only 16 patients (8.4%) were diagnosed with CDI. Ribotype 078/126 (25.0%) was the most frequently identified. The mortality rate was similar in patients with ICD compared to patients with diarrhea not caused by C. difficile (p=0.115). Chronic renal insufficiency was identified as the only factor independently associated with the development of CDI (OR 5.87, 95% CI 1.24-27.83; p=0.026).
CONCLUSIONS
The incidence of CDI in Spanish ICUs is low. Only chronic renal insufficiency was observed to be a risk factor for CDI development.
引言
我们的目标是描述重症患者艰难梭菌感染（CDI）的发病率、临床特征和危险因素，并确定艰难梭菌的PCR核糖体分型。
方法
在26家西班牙重症监护病房进行前瞻性观察研究。纳入符合欧洲临床微生物和感染性疾病学会（ESCMID）CDI标准的腹泻患者。使用PCR核糖体分型对分离株进行分子特征分析。
结果
在入住重症监护病房的4258例患者中，190例（4.5%）出现腹泻。仅16例（8.4%）被诊断为CDI。核糖体分型078/126（25.0%）是最常鉴定出的类型。与非艰难梭菌引起腹泻的患者相比，CDI患者的死亡率相似（p = 0.115）。慢性肾功能不全被确定为与CDI发生独立相关的唯一因素（比值比5.87，95%置信区间1.24 - 27.83；p = 0.026）。
结论
西班牙重症监护病房中CDI的发病率较低。仅观察到慢性肾功能不全是CDI发生的一个危险因素。
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