艰难梭菌感染在长期疗养医院：一个真正的陷阱和过时治疗的故事。
Clostridioides difficile infection in a long-term convalescence hospital: A real tale of pitfalls and outdated therapy.
机构信息
Ángel García-Forcada. Hospital San Juan de Dios, Paseo Colón 14, 50006 Zaragoza, Spain.
出版信息
Rev Esp Quimioter. 2021 Feb;34(1):51-55. doi: 10.37201/req/085.2020. Epub 2020 Dec 1.
OBJECTIVE
The aim of the study was to know the characteristics and risk factors of Clostridioides difficile infection (CDI) in a long-term hospital is key to improve its management.
METHODS
Retrospective study with 37 patients, along 43 months. We describe demographic variables, clinical data, time to diagnosis, treatment, and evolution.
RESULTS
Analysis of 46 episodes (37 patients, mean age=82.2 years). 77.8% were absolutely dependent, 41.7% had chronic kidney disease, 64.9% had received antibiotics in the previous three months, 40.5% received antibiotics at diagnosis. It was the first episode in 78.4%, and first recurrence in 21.6%. Therapy was started in the first 24 hours after diagnosis in 89.2%, mostly metronidazole. 83.3% recovered, 3 patients died from CDI, diagnosis was registered in the discharge report in 91.1%.
CONCLUSIONS
Previous antibiotic therapy, high grade of dependency and renal failure were the main risk factors. There is room for improvement in CDI management at our hospital.
目的
研究的目的是了解长期住院患者艰难梭菌感染（CDI）的特征和危险因素，这是改善其管理的关键。
方法
对 37 例患者的 43 个月进行回顾性研究。我们描述了人口统计学变量、临床数据、诊断时间、治疗和转归。
结果
分析了 46 例（37 例患者，平均年龄 82.2 岁）。77.8%的患者完全依赖，41.7%的患者患有慢性肾脏病，64.9%的患者在过去三个月内使用过抗生素，40.5%的患者在诊断时使用过抗生素。78.4%的患者为首次发作，21.6%的患者为首次复发。诊断后 24 小时内开始治疗的占 89.2%，主要使用甲硝唑。83.3%的患者痊愈，3 例患者死于 CDI，出院报告中记录了 91.1%的诊断。
结论
既往抗生素治疗、高度依赖和肾功能衰竭是主要的危险因素。我们医院在 CDI 管理方面还有改进的空间。
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