Provincial Centre for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Provincial Centre for Clinical Laboratories, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China; Department of Clinical Laboratory, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
J Hosp Infect. 2022 Dec;130:112-121. doi: 10.1016/j.jhin.2022.09.004. Epub 2022 Sep 13.
Clostridioides difficile is considered an urgent threat to human health by the US Centers for Disease Control and Prevention. In recent years, C. difficile has been reported increasingly as a cause of gastrointestinal disease in children, and the prevalence of hospital-acquired C. difficile infection and community-acquired CDI in children is increasing.
To perform a systematic review and meta-analysis of risk factors for CDI in children.
MEDLINE/PubMed, EMBASE, Web of Science, Scopus, OVID, China National Knowledge Infrastructure, Wanfang (Chinese), SinoMed (Chinese) and Weipu (Chinese) were searched from inception to 12 January 2022. Observational studies (cohort, case-control and cross-sectional) on CDI in children were included in the analysis. Data were pooled using a fixed or random-effects model, and odds ratios (OR) were calculated.
In total, 25 observational studies were included in the analysis. Prior antibiotic exposure [OR 1.93, 95% confidence interval (CI) 1.25-2.97], prolonged hospitalization (OR 14.68, 95% CI 13.24-16.28), history of hospitalization (OR 3.67, 95% CI 1.91-7.06), gastric acid suppressants (OR 1.96, 95% CI 1.41-2.73), male gender (OR 1.18, 95% CI 1.05-1.32), neoplastic disease (OR 3.40, 95% CI, 2.85-4.07), immunodeficiency (OR 4.18, 95% CI 3.25-5.37), solid organ transplantation (OR 4.56, 95% CI 3.95-5.27) and enteral feeding (OR 2.21, 95% CI 1.05-4.62) were associated with increased risk of CDI.
This systematic review and meta-analysis provides further evidence for the susceptibility factors of CDI to improve clinicians' awareness of CDI, and prevent C. difficile-associated diarrhoea in children.
艰难梭菌被美国疾病控制与预防中心视为对人类健康的紧急威胁。近年来，艰难梭菌在儿童中被越来越多地报告为胃肠道疾病的病因，儿童中医院获得性艰难梭菌感染和社区获得性 CDI 的患病率正在上升。
对儿童艰难梭菌感染的危险因素进行系统回顾和荟萃分析。
从建库至 2022 年 1 月 12 日，检索 MEDLINE/PubMed、EMBASE、Web of Science、Scopus、OVID、中国知网、万方、中国生物医学文献服务系统和维普数据库，纳入儿童艰难梭菌感染的观察性研究（队列研究、病例对照研究和横断面研究）。采用固定或随机效应模型进行数据合并，并计算比值比（OR）。
共纳入 25 项观察性研究。既往抗生素暴露（OR 1.93，95%置信区间 [CI] 1.25-2.97）、住院时间延长（OR 14.68，95%CI 13.24-16.28）、住院史（OR 3.67，95%CI 1.91-7.06）、胃酸抑制剂（OR 1.96，95%CI 1.41-2.73）、男性（OR 1.18，95%CI 1.05-1.32）、肿瘤疾病（OR 3.40，95%CI，2.85-4.07）、免疫缺陷（OR 4.18，95%CI 3.25-5.37）、实体器官移植（OR 4.56，95%CI 3.95-5.27）和肠内喂养（OR 2.21，95%CI 1.05-4.62）与 CDI 风险增加相关。
本系统回顾和荟萃分析为 CDI 的易感性因素提供了进一步的证据，以提高临床医生对 CDI 的认识，并预防儿童艰难梭菌相关性腹泻。
