墨西哥外科手术患者中与艰难梭菌相关的腹泻。
Clostridioides difficile-associated diarrhea in surgical service patients in Mexico.
机构信息
Servicio de Infectología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México; Instituto de Patología Infecciosa y Experimental, Centro Universitario de Ciencias de la Salud, Universidad de Guadalajara, Guadalajara, Jalisco, México.
Servicio de Infectología, Hospital Civil de Guadalajara Fray Antonio Alcalde, Guadalajara, Jalisco, México.
出版信息
Rev Gastroenterol Mex (Engl Ed). 2020 Jul-Sep;85(3):227-234. doi: 10.1016/j.rgmx.2019.05.003. Epub 2019 Aug 12.
INTRODUCTION
Clostridioides difficile is the first cause of healthcare-associated diarrhea in developed countries. In recent years the incidence of C. difficile infection (CDI) has increased worldwide. There is not much information on the topic in Mexico, and little is known about the risk factors for the infection in patients that are hospitalized in surgical services.
MATERIALS AND METHODS
A case-control study was conducted that compared the epidemiologic findings and risk factors between surgical patients with PCR-confirmed CDI, surgical patients with diarrhea and a negative PCR test, and surgical patients with no diarrhea. The statistical analysis was carried out using the SPSS version 22.0 program.
RESULTS
The majority of the surgical patients with CDI belonged to the areas of neurosurgery, cardiac surgery, orthopedics, and general surgery. A total of 53% of the CDI cases were associated with the hypervirulent CD NAP1/027 strain. The presence of mucus in stools (OR: 1.5, P=.001), fever (OR: 1.4, P=.011), leukocytes in stools (OR: 3.2, P<.001), hospitalization within the past 12weeks (OR: 2.0, P<.001), antibiotic use (OR: 1.3, P=.023), and ceftriaxone use (OR: 1.4, P=.01) were independent risk factors for the development of CDI.
CONCLUSIONS
C. difficile-induced diarrhea in the surgical services is frequent at the Hospital Civil de Guadalajara "Fray Antonio Alcalde".
介绍
艰难梭菌是发达国家中与医疗保健相关的腹泻的首要原因。近年来，艰难梭菌感染（CDI）的发病率在全球范围内有所增加。在墨西哥，关于这个主题的信息不多，对于在外科服务中住院的患者感染的危险因素也知之甚少。
材料和方法
进行了一项病例对照研究，比较了经 PCR 确认的 CDI 外科患者、腹泻且 PCR 检测呈阴性的外科患者和无腹泻的外科患者的流行病学发现和危险因素。使用 SPSS 版本 22.0 程序进行统计分析。
结果
大多数患有 CDI 的外科患者属于神经外科、心脏外科、骨科和普通外科领域。共有 53%的 CDI 病例与高毒力 CD NAP1/027 菌株有关。粪便中有粘液（OR：1.5，P=.001）、发热（OR：1.4，P=.011）、粪便中有白细胞（OR：3.2，P<.001）、过去 12 周内住院（OR：2.0，P<.001）、抗生素使用（OR：1.3，P=.023）和头孢曲松使用（OR：1.4，P=.01）是 CDI 发展的独立危险因素。
结论
瓜达拉哈拉“Fray Antonio Alcalde”公民医院外科服务中艰难梭菌引起的腹泻很常见。
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