Lis Łukasz, Konieczny Andrzej, Sroka Michał, Ciszewska Anna, Krakowska Kornelia, Gołębiowski Tomasz, Hruby Zbigniew
Research and Development Center, Department of Nephrology, Provincial Specialist Hospital, Kamienskiego 73a, 51-124 Wroclaw, Poland.
Department of Internal Medicine, University Hospital, Witosa 23, 45-401 Opole, Poland.
Antibiotics (Basel). 2022 Jun 8;11(6):785. doi: 10.3390/antibiotics11060785.
The majority of recently published studies indicate a greater incidence rate and mortality due to Clostridioides difficile infection (CDI) in patients with chronic kidney disease (CKD). The aim of this study was to assess the clinical determinants predicting CDI among hospitalized patients with CKD and refine methods of prevention. We evaluated the medical records of 279 patients treated at a nephrological department with symptoms suggesting CDI, of whom 93 tested positive for CDI. The survey showed that age, poor kidney function, high Padua prediction score (PPS) and patients' classification of care at admission, treatment with antibiotics, and time of its duration were significantly higher or more frequent among patients who suffered CDI. Whereas BMI, Norton scale (ANSS) and serum albumin concentration were significantly lowered among CDI patients. In a multivariate analysis we proved the stage of CKD and length of antibiotics use increased the risk of CDI, whereas higher serum albumin concentration and ANSS have a protective impact.
最近发表的大多数研究表明，慢性肾脏病（CKD）患者中艰难梭菌感染（CDI）的发病率和死亡率更高。本研究的目的是评估预测CKD住院患者发生CDI的临床决定因素，并完善预防方法。我们评估了279例在肾脏病科接受治疗且有CDI症状的患者的病历，其中93例CDI检测呈阳性。调查显示，在发生CDI的患者中，年龄、肾功能差、高帕多瓦预测评分（PPS）、患者入院时的护理分类、抗生素治疗及其持续时间显著更高或更频繁。而CDI患者的体重指数、诺顿量表（ANSS）和血清白蛋白浓度显著降低。在多变量分析中，我们证明CKD分期和抗生素使用时间增加了CDI风险，而较高的血清白蛋白浓度和ANSS具有保护作用。
