Medical College of Georgia, Augusta University, Augusta, Georgia, USA.
Department of Psychiatry and Health behavior, Augusta University, Augusta, Georgia, USA.
Ann Clin Psychiatry. 2022 Nov;34(4):221-226. doi: 10.12788/acp.0075.
There is an increased prevalence of recent antimicrobial exposure in patients with acute psychosis. We previously found recurrent urinary tract infections (UTIs) in some patients with psychosis. We evaluated the prevalence of recurrent antimicrobial exposure in acutely ill inpatients with psychosis.
We performed a retrospective chart review of 85 patients age 18 to 65 with multiple hospitalizations for acute psychosis. Antimicrobial exposure was defined as occurring within 3 days of each psychiatric hospitalization. Recurrent infections were defined as antimicrobial exposure during ≥2 separate hospitalizations for acute psychosis.
The prevalence of recurrent antimicrobial exposure was 26% (22/85), including 25% (13/51) in patients with schizophrenia and 26% (9/34) in patients with psychotic mood disorders. Patients with schizophrenia and recurrent antimicrobial exposure were significantly more likely to have visual hallucinations in admissions with infection vs without (31% vs 14%, respectively, P = .04).
We found that a subset of patients with schizophrenia and psychotic mood disorders has recurrent infections at the time of hospitalization for acute psychosis. Findings replicate an association between recurrent UTIs and acute psychosis. Although the mechanism of this association remains unclear, findings provide additional evidence that infections may be relevant to illness relapse in some patients with psychosis.
急性精神病患者近期接触抗生素的情况更为普遍。我们之前发现一些精神病患者经常发生尿路感染（UTI）。我们评估了急性精神病住院患者中反复接触抗生素的发生率。
我们对 85 名年龄在 18 至 65 岁之间的多次因急性精神病住院的患者进行了回顾性图表审查。抗生素暴露定义为每次精神病住院前 3 天内发生。复发性感染定义为在≥2 次急性精神病住院期间发生的抗生素暴露。
反复接触抗生素的发生率为 26%（22/85），其中精神分裂症患者为 25%（13/51），精神病性情感障碍患者为 26%（9/34）。在有感染的住院治疗中，有反复抗生素暴露的精神分裂症患者出现幻觉的可能性明显高于无感染的患者（分别为 31%和 14%，P =.04）。
我们发现，一部分精神分裂症和精神病性情感障碍患者在急性精神病住院期间反复发生感染。这一发现再现了复发性尿路感染与急性精神病之间的关联。尽管这种关联的机制尚不清楚，但这些发现提供了更多证据表明，感染可能与一些精神病患者的疾病复发有关。
