Lang Vanessa, Gunka Katrin, Ortlepp Jan Rudolf, Zimmermann Ortrud, Groß Uwe
Institute of Medical Microbiology, University Medical Center Göttingen, Göttingen, Germany.
Asklepios Kliniken Schildautal Seesen, Seesen, Germany.
Front Microbiol. 2022 Mar 11;13:840846. doi: 10.3389/fmicb.2022.840846. eCollection 2022.
Nosocomial infections with have become an emergent health threat. We sought to define risk factors for a infection (CDI) beyond the widely known ones, such as antibiotic use and prior hospital stay. We therefore focused on a group of patients with diarrhea in order to identify risk factors for infection among this symptomatic cohort. A total of 121 hospitalized patients from Seesen/Germany with diarrhea were included who submitted a stool sample and were interviewed about their socio-demographic background, lifestyle and state of health using a standardized questionnaire. Antibiotic potential of diuretics was examined by agar diffusion test. was identified in 29 patients resulting in a prevalence of 24.0%. The infection was hospital-acquired in most cases ( < 0.001, 82.1%; = 23/28, versus 29/91, 31.9%). The generally accepted risk factor previous antibiotic use was confirmed in this study ( = 0.002, = 23/28 CDI patients, 82.1%, versus = 44/91 non-CDI patients, 48.4%). The following additional risk factors were identified: regular consumption of proton pump inhibitors; PPI ( = 0.011, = 24/29, 82.8% vs. = 52/92, 56.5%), CDI patients ate less vegetables ( = 0.001, = 12/29, 41.4% vs. 69/92, 75.0%). The intake of the diuretic agent torasemid in patients with CDI ( = 0.005, = 18/29, 62.1%) was higher than in patients without ( = 30/92, 32.6%). More patients with CDI had to undergo a surgery in the previous year ( = 0.022, = 13/29, 44.8% vs. = 21/92, 22.8%) and held more birds ( = 0.056, = 4/29, 13.8%) than individuals of the negative group ( = 3/92, 3.3%). In conclusion, although no antibiotic potential was detected in diuretics, especially torasemid seems to have significant influence for the occurrence of a CDI as well as a nutrition poor in vegetables. A diet rich in vegetables represented a fourfold lower risk for a CDI (OR 0.240, CI (0.0720 - 0.796]).
艰难梭菌医院感染已成为一种新出现的健康威胁。我们试图确定除了抗生素使用和既往住院史等广为人知的因素之外的艰难梭菌感染（CDI）风险因素。因此，我们聚焦于一组腹泻患者，以确定这一有症状队列中的艰难梭菌感染风险因素。纳入了来自德国塞森的121名因腹泻住院的患者，他们提交了粪便样本，并使用标准化问卷接受了关于其社会人口学背景、生活方式和健康状况的访谈。通过琼脂扩散试验检测利尿剂的抗生素潜力。29名患者检测出艰难梭菌，患病率为24.0%。大多数病例的感染是医院获得性的（P<0.001，82.1%；n = 23/28，相比29/91，31.9%）。本研究证实了普遍认可的风险因素——既往使用抗生素（P = 0.002，28例CDI患者中有23例，82.1%，相比91例非CDI患者中有44例，48.4%）。还确定了以下额外风险因素：经常服用质子泵抑制剂；PPI（P = 0.011，29例中有24例，82.8% vs. 92例中有52例，56.5%），CDI患者蔬菜摄入量较少（P = 0.001，29例中有12例，41.4% vs. 92例中有69例，75.0%）。CDI患者中托拉塞米利尿剂的摄入量（P = 0.005，29例中有18例，62.1%）高于非CDI患者（92例中有30例，32.6%）。更多的CDI患者在前一年不得不接受手术（P = 0.022，29例中有13例，44.8% vs. 92例中有21例，22.8%），并且比阴性组个体饲养更多鸟类（P = 0.056，29例中有4例，13.8% vs. 92例中有3例，3.3%）。总之，尽管在利尿剂中未检测到抗生素潜力，但特别是托拉塞米似乎对CDI的发生以及蔬菜摄入不足有重大影响。富含蔬菜的饮食使CDI风险降低四倍（OR 0.240，CI(0.0720 - 0.796]）。
