Kwon Soon Sung, Gim Jung Lim, Kim Myung Sook, Kim Heejung, Choi Jun Yong, Yong Dongeun, Lee Kyungwon
Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.
Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, South Korea.
Anaerobe. 2017 Dec;48:42-46. doi: 10.1016/j.anaerobe.2017.06.014. Epub 2017 Jun 24.
Community-acquired Clostridium difficile infection (CA-CDI) is a growing concern. CA-CDI differs from hospital-acquired C. difficile infection (HA-CDI) in its epidemiology, risk factors, severity, and outcomes. In this study, we investigated C. difficile infections in a tertiary care hospital in Seoul, Korea, and compared the CA-CDI and HA-CDI cases diagnosed in the same period. Total 593 cases were confirmed as CDI in 2014, of which CA-CDI accounted for 68 (11.5%) of the total CDI cases. Compared with HA-CDI, the mean age of CA-CDI cases was lower than that of HA-CDI (42.7 vs 60.4). In CA-CDI, antibiotic and proton pump inhibitor (PPI) use in the 12 preceding weeks and concurrent chemotherapy and tube feeding were less frequent compared with HA-CDI. In most cases (63/68, 92.6%), patients with CA-CDI recovered without any complications or recurrence. The most prevalent C. difficile type in CA-CDI cases was PCR-ribotype 012, accounting for 18.3% of the total, followed by PCR-ribotype 018 (16.7%).
社区获得性艰难梭菌感染（CA-CDI）日益受到关注。CA-CDI在流行病学、危险因素、严重程度和结局方面与医院获得性艰难梭菌感染（HA-CDI）有所不同。在本研究中，我们调查了韩国首尔一家三级医疗中心的艰难梭菌感染情况，并比较了同期诊断的CA-CDI和HA-CDI病例。2014年共确诊593例CDI病例，其中CA-CDI占CDI总病例数的68例（11.5%）。与HA-CDI相比，CA-CDI病例的平均年龄低于HA-CDI（42.7岁对60.4岁）。与HA-CDI相比，CA-CDI患者在之前12周内使用抗生素和质子泵抑制剂（PPI）以及同时进行化疗和管饲的情况较少。在大多数病例（63/68，92.6%）中，CA-CDI患者康复且无任何并发症或复发。CA-CDI病例中最常见的艰难梭菌类型是PCR核糖体分型012，占总数的18.3%，其次是PCR核糖体分型018（16.7%）。
