Dharbhamulla Nikhita, Abdelhady Ahmed, Domadia Mona, Patel Sanket, Gaughan John, Roy Satyajeet
Department of Internal Medicine at Cooper University Hospital, 1103 North Kings Highway Suite 203, Cherry Hill, NJ 08034, USA.
Cooper Medical School of Rowan University, 401 Broadway Street, Camden, NJ 08103, USA.
J Clin Med Res. 2019 Jan;11(1):1-6. doi: 10.14740/jocmr3531w. Epub 2018 Dec 3.
Recurrence of infection (CDI) is a problem that can cost up to $20,000 each year in the United States. Studies have reported risk factors that may be associated with a higher incidence of recurrent CDI. We studied additional risk factors, including history of partial colectomy, chemotherapy use and hospitalization in the intensive care unit (ICU).
We conducted a retrospective chart review of all outpatients and inpatients at our institution to determine risk factors associated with recurrent CDI. Frequencies were compared using Fisher's exact test and continuous data were compared using Wilcoxon ranks sums test. Recurrent CDI was determined for all patients and risk factors were analyzed using single and multiple logistic regression. A P < 0.05 was used to determine significance.
This study included 435 patients and found that advanced age significantly increased the odds of recurrent CDI by 2.3% per year (OR = 1.023, 95% CI = 1.009 - 1.037, P < 0.05). Patients with prior partial colectomy were found to have 3.2 times increased odds of recurrence compared to those without history of partial colectomy (OR = 3.168, 95% CI = 1.324 - 7.579, P < 0.05). Patients receiving chemotherapy or hospitalized in the ICU were not found to have a significantly higher rate of recurrent CDI (P > 0.05).
Advanced age and history of partial colectomy were associated with a significantly higher recurrence rate of CDI. Contrary to prior studies, chemotherapy use or hospitalization in the ICU were not found to be associated with a higher rate of recurrent CDI.
在美国,艰难梭菌感染(CDI)复发是一个每年可能花费高达20,000美元的问题。研究报告了可能与复发性CDI较高发病率相关的风险因素。我们研究了其他风险因素,包括部分结肠切除术史、化疗使用情况和在重症监护病房(ICU)住院情况。
我们对本机构所有门诊和住院患者进行了回顾性病历审查,以确定与复发性CDI相关的风险因素。使用Fisher精确检验比较频率,使用Wilcoxon秩和检验比较连续数据。确定所有患者的复发性CDI,并使用单因素和多因素逻辑回归分析风险因素。P < 0.05用于确定显著性。
本研究纳入了435例患者,发现高龄显著增加复发性CDI的几率,每年增加2.3%(OR = 1.023,95% CI = 1.009 - 1.037,P < 0.05)。与无部分结肠切除术史的患者相比,有部分结肠切除术史的患者复发几率增加3.2倍(OR = 3.168,95% CI = 1.324 - 7.579,P < 0.05)。未发现接受化疗或在ICU住院的患者复发性CDI发生率显著更高(P > 0.05)。
高龄和部分结肠切除术史与CDI的复发率显著较高相关。与先前的研究相反,未发现化疗使用或在ICU住院与复发性CDI的较高发生率相关。