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Clinical Practice Guidelines for Clostridium difficile Infection in Adults and Children: 2017 Update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA).临床实践指南:成人和儿童艰难梭菌感染:美国传染病学会(IDSA)和美国医疗保健流行病学学会(SHEA) 2017 年更新。
Clin Infect Dis. 2018 Mar 19;66(7):e1-e48. doi: 10.1093/cid/cix1085.
2
Protective Factors in the Intestinal Microbiome Against Clostridium difficile Infection in Recipients of Allogeneic Hematopoietic Stem Cell Transplantation.异基因造血干细胞移植受者肠道微生物群中抵抗艰难梭菌感染的保护因素
J Infect Dis. 2017 Apr 1;215(7):1117-1123. doi: 10.1093/infdis/jix011.
3
Infections in Hematopoietic Cell Transplant Recipients: Results From the Organ Transplant Infection Project, a Multicenter, Prospective, Cohort Study.造血干细胞移植受者的感染:多中心前瞻性队列研究“器官移植感染项目”的结果
Open Forum Infect Dis. 2017 Mar 22;4(2):ofx050. doi: 10.1093/ofid/ofx050. eCollection 2017 Spring.
4
Evaluating Risk Factors for Clostridium difficile Infection In Stem Cell Transplant Recipients: A National Study.评估干细胞移植受者艰难梭菌感染的风险因素:一项全国性研究。
Infect Control Hosp Epidemiol. 2017 Jun;38(6):651-657. doi: 10.1017/ice.2017.12. Epub 2017 Mar 23.
5
Evaluation of Risk Factors for Clostridium difficile Infection in Hematopoietic Stem Cell Transplant Recipients.造血干细胞移植受者艰难梭菌感染危险因素的评估
Pharmacotherapy. 2017 Apr;37(4):420-428. doi: 10.1002/phar.1914. Epub 2017 Mar 30.
6
Bezlotoxumab for Prevention of Recurrent Clostridium difficile Infection.贝洛妥珠单抗预防复发性艰难梭菌感染。
N Engl J Med. 2017 Jan 26;376(4):305-317. doi: 10.1056/NEJMoa1602615.
7
Risk factors and epidemiology of Clostridium difficile infection in hematopoietic stem cell transplant recipients during the peritransplant period.造血干细胞移植受者围移植期艰难梭菌感染的危险因素及流行病学
Transpl Infect Dis. 2017 Feb;19(1). doi: 10.1111/tid.12649.
8
Risk factors for the development of Clostridium difficile infection in adult allogeneic hematopoietic stem cell transplant recipients: A single-center study in Québec, Canada.成年异基因造血干细胞移植受者发生艰难梭菌感染的危险因素:加拿大魁北克的一项单中心研究。
Transpl Infect Dis. 2017 Feb;19(1). doi: 10.1111/tid.12648. Epub 2017 Jan 11.
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Clostridium difficile Infection in Special High-Risk Populations.特殊高危人群中的艰难梭菌感染。
Infect Dis Ther. 2016 Sep;5(3):253-69. doi: 10.1007/s40121-016-0124-z. Epub 2016 Aug 11.
10
Significance of a positive Clostridium difficile toxin test after hematopoietic stem cell transplantation.造血干细胞移植后艰难梭菌毒素检测呈阳性的意义
Clin Transplant. 2016 Jun;30(6):703-8. doi: 10.1111/ctr.12737. Epub 2016 Apr 21.

造血干细胞移植患者感染管理策略的单中心经验及文献综述

A Single-Center Experience and Literature Review of Management Strategies for Infection in Hematopoietic Stem Cell Transplant Patients.

作者信息

Majeed Aneela, Larriva Marti M, Iftikhar Ahmad, Mushtaq Adeela, Campbell Patrick, Nadeem Malik Mustafa, Rafae Abdul, Zar Muhammad Abu, Kamal Ahmad, Lakhani Midhat, Khalid Nageena Rani, Zangeneh Tirdad T, Anwer Faiz

机构信息

Department of Medicine, Division of Infectious Diseases, Stanford University, Stanford, CA.

Department of Pharmacy, University of Arizona, Tucson, AZ.

出版信息

Infect Dis Clin Pract (Baltim Md). 2020 Jan;28(1):10-15. doi: 10.1097/ipc.0000000000000798.

DOI:10.1097/ipc.0000000000000798
PMID:33424210
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC7792527/
Abstract

INTRODUCTION

The aim of our study is to evaluate risk factors associated with the development of infection (CDI) in hematopoietic stem cell transplant (HSCT) patients, determine its incidence and report outcomes of CDI in our patient population.

METHODS

We performed a retrospective review of medical records of adult HSCT recipients diagnosed between 2013 and 2016 at our center. Logistic regression models were used to determine the relationship between risk factors and the odds of CDI.

RESULTS

The overall incidence of CDI in HSCT patients was 9.4%. The incidence of CDI was higher in allogeneic HSCT (20%) versus autologous HSCT (4.8%). No statistically significant differences in age, gender, cancer type, transplant type were found between those who developed CDI and those who did not. However, patients with CDI had a longer length of stay (25 days) and used more antibiotics (30 days prior to and during admission for HSCT) than non-CDI patients (19 days). Only two of 17 patients (11.8%) with CDI experienced recurrence among 180 patients after HSCT. No patient suffered from toxic megacolon or ileus and no patient underwent colectomy. There was no mortality associated with CDI at our center.

CONCLUSION

CDI has an incidence rate of 9.4% in HSCT recipients. Established risk factors including age, gender, cancer type, and transplant type were not identified as risk factors in our population. However, longer LOS and use of greater than four lines of antibiotics were observed among those with CDI compared to those without CDI.

摘要

引言

我们研究的目的是评估造血干细胞移植(HSCT)患者发生艰难梭菌感染(CDI)的相关危险因素,确定其发病率并报告我们患者群体中CDI的结局。

方法

我们对2013年至2016年在本中心诊断的成年HSCT受者的病历进行了回顾性研究。采用逻辑回归模型确定危险因素与CDI发生几率之间的关系。

结果

HSCT患者中CDI的总体发病率为9.4%。异基因HSCT(20%)中CDI的发病率高于自体HSCT(4.8%)。发生CDI的患者与未发生CDI的患者在年龄、性别、癌症类型、移植类型方面未发现统计学上的显著差异。然而,CDI患者的住院时间更长(25天),且在HSCT入院前及住院期间使用的抗生素更多(30天),而非CDI患者为19天。17例CDI患者中只有2例(11.8%)在HSCT后的180例患者中出现复发。没有患者发生中毒性巨结肠或肠梗阻,也没有患者接受结肠切除术。在我们中心,CDI未导致死亡。

结论

HSCT受者中CDI的发病率为9.4%。年龄、性别、癌症类型和移植类型等既定危险因素在我们的人群中未被确定为危险因素。然而,与未发生CDI的患者相比,发生CDI的患者住院时间更长,且使用了超过四种抗生素。