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艰难梭菌感染对住院患者的影响:疫情期间有哪些变化?

The Impact of Clostridioides Difficile Infection in Hospitalized Patients: What Changed during the Pandemic?

作者信息

Boeriu Alina, Roman Adina, Dobru Daniela, Stoian Mircea, Voidăzan Septimiu, Fofiu Crina

机构信息

Gastroenterology Department, University of Medicine Pharmacy, Sciences, and Technology "George Emil Palade" Targu Mures, 540142 Targu Mures, Romania.

Gastroenterology Department, Mureș County Clinical Hospital, 540103 Targu Mures, Romania.

出版信息

Diagnostics (Basel). 2022 Dec 16;12(12):3196. doi: 10.3390/diagnostics12123196.

Abstract

(1) Background: () and SARS-CoV-2 coronavirus represent significant health threats. Our study focused on the impact of concurrent infections on patient outcomes against the backdrop of changes imposed by the pandemic. (2) Materials and methods. We performed a retrospective analysis and included patients diagnosed with CDI who were admitted in our hospital before and during the pandemic. We compared patient exposure to risk factors for CDI in both groups and patient negative outcomes: need for ICU care, prolonged hospitalization, organ failure, toxic megacolon, and death. (3) Results. Overall, 188 patients were included, of which 100 had CDI (the pre-pandemic group), and 88 patients presented both CDI and COVID-19 (the pandemic group). Patients in the pandemic group were significantly older, with a higher Charlson Comorbidity Index (CCI) and a greater exposure to antibiotics and corticosteroids, and were more likely to develop organ dysfunction, to require ICU care and have prolonged hospitalization. The severity of COVID-19, leukocytosis and increased D-dimer levels were indicators of poor prognosis in the pandemic group. Higher CCI scores and leukocytosis increased the risk for negative outcomes in CDI alone patients. (4) Conclusions. The study highlights the negative impact of associated infections on patient outcome. The severity of COVID-19 directly influences the prognosis of patients with concurrent infections.

摘要

(1) 背景:()和严重急性呼吸综合征冠状病毒2(SARS-CoV-2)对健康构成重大威胁。我们的研究聚焦于在疫情带来的变化背景下,合并感染对患者预后的影响。(2) 材料与方法。我们进行了一项回顾性分析,纳入了在疫情前及疫情期间入住我院且被诊断为艰难梭菌感染(CDI)的患者。我们比较了两组患者接触CDI危险因素的情况以及患者的不良结局:入住重症监护病房(ICU)的需求、住院时间延长、器官衰竭、中毒性巨结肠和死亡。(3) 结果。总体而言,共纳入188例患者,其中100例患有CDI(疫情前组),88例患者同时患有CDI和2019冠状病毒病(COVID-19)(疫情组)。疫情组患者年龄显著更大,查尔森合并症指数(CCI)更高,接触抗生素和皮质类固醇的情况更多,且更有可能出现器官功能障碍,需要入住ICU并延长住院时间。COVID-19的严重程度、白细胞增多和D-二聚体水平升高是疫情组预后不良的指标。较高的CCI评分和白细胞增多增加了单纯CDI患者出现不良结局的风险。(4) 结论。该研究突出了合并感染对患者预后的负面影响。COVID-19的严重程度直接影响合并感染患者的预后。

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