Borren Nienke Z, Ghadermarzi Shadi, Hutfless Susan, Ananthakrishnan Ashwin N
Division of Gastroenterology, Massachusetts General Hospital, Boston, Massachusetts, United States of America.
University of Groningen, Groningen, The Netherlands.
PLoS One. 2017 May 2;12(5):e0176797. doi: 10.1371/journal.pone.0176797. eCollection 2017.
Clostridium difficile infection (CDI) is the most common healthcare associated infection and is highly prevalent in Europe and North America. Limited data is available on the prevalence of CDI in Asia. However, secular increases in prevalence of risk factors for CDI suggest that it may be emerging as a major cause of morbidity, highlighting the urgent need for a systematic study of the prevalence of CDI in Asia.
We systematically searched PubMed/Medline and Embase for publications from Asia between 2000-16 examining prevalence of CDI. A random-effects meta-analysis was performed to calculate the pooled prevalence of CDI in Asia and to identify subgroups and regions at high risk.
Our meta-analysis included 51 studies from throughout Asia including 37,663 patients at risk among whom confirmed CDI was found in 4,343 patients. The pooled proportion of confirmed CDI among all patients with diarrhea was 14.8% with a higher prevalence in East Asia (19.5%), compared with South Asia (10.5%) or the Middle East (11.1%). There were an estimated 5.3 episodes of CDI per 10,000 patient days, similar to rates reported from Europe and North America. Infections due to hypervirulent strains were rare. CDI-related mortality was 8.9%.
In a meta-analysis of 51 studies, we observed similar rates of CDI in Asia in comparison to Europe and North America. Increased awareness and improved surveillance of Clostridium difficile is essential to reduce incidence and morbidity.
艰难梭菌感染（CDI）是最常见的医疗保健相关感染，在欧洲和北美高度流行。关于亚洲CDI患病率的数据有限。然而，CDI危险因素患病率的长期上升表明，它可能正在成为发病的主要原因，这突出了对亚洲CDI患病率进行系统研究的迫切需求。
我们系统检索了PubMed/Medline和Embase，以查找2000年至2016年间亚洲关于CDI患病率的出版物。进行随机效应荟萃分析，以计算亚洲CDI的合并患病率，并确定高危亚组和地区。
我们的荟萃分析纳入了来自亚洲各地的51项研究，包括37663名有风险的患者，其中4343名患者被确诊为CDI。所有腹泻患者中确诊CDI的合并比例为14.8%，东亚的患病率较高（19.5%），而南亚（10.5%）或中东（11.1%）的患病率较低。每10000个患者日估计有5.3次CDI发作，与欧洲和北美报告的发病率相似。高毒力菌株引起的感染很少见。CDI相关死亡率为8.9%。
在对51项研究的荟萃分析中，我们观察到亚洲的CDI发病率与欧洲和北美相似。提高对艰难梭菌的认识并加强监测对于降低发病率至关重要。
