De Roo Ana C, Regenbogen Scott E
Center for Healthcare Outcomes and Policy, University of Michigan, Ann Arbor, Michigan.
Department of Surgery, University of Michigan, Ann Arbor, Michigan.
Clin Colon Rectal Surg. 2020 Mar;33(2):49-57. doi: 10.1055/s-0040-1701229. Epub 2020 Feb 25.
(reclassified as " ") infection (CDI) is a healthcare-associated infection and significant source of potentially preventable morbidity, recurrence, and death, particularly among hospitalized older adults. Additional risk factors include antibiotic use and severe underlying illness. The increasing prevalence of community-associated CDI is gaining recognition as a novel source of morbidity in previously healthy patients. Even after recovery from initial infection, patients remain at risk for recurrence or reinfection with a new strain. Some pharmaco-epidemiologic studies have suggested an increased risk associated with proton pump inhibitors and protective effect from statins, but these findings have not been uniformly reproduced in all studies. Certain ribotypes of , including the BI/NAP1/027, 106, and 018, are associated with increased antibiotic resistance and potential for higher morbidity and mortality. CDI remains a high-morbidity healthcare-associated infection, and better understanding of ribotypes and medication risk factors could help to target treatment, particularly for patients with high recurrence risk.
(重新分类为“ ”)感染(CDI)是一种医疗保健相关感染,是潜在可预防的发病、复发和死亡的重要来源,尤其是在住院的老年人中。其他风险因素包括抗生素使用和严重的基础疾病。社区获得性CDI患病率的上升正日益被视为先前健康患者发病的新来源。即使从初始感染中恢复后,患者仍有复发或感染新菌株的风险。一些药物流行病学研究表明,质子泵抑制剂会增加风险,而他汀类药物具有保护作用,但这些发现并非在所有研究中都能一致重现。某些 的核糖型,包括BI/NAP1/027、106和018,与抗生素耐药性增加以及更高的发病和死亡风险相关。CDI仍然是一种高发病率的医疗保健相关感染,更好地了解核糖型和药物风险因素有助于针对性治疗,特别是对于复发风险高的患者。