在瑞典环境下，复发性医疗机构相关性艰难梭菌感染的危险因素。
Risk factors for recurrent healthcare-facility associated Clostridioides difficile infection in a Swedish setting.
机构信息
Department of Infectious Diseases, Skaraborg Hospital, Lövängsvägen, 451 42, Skövde, Sweden; Center for Antibiotic Resistance Research (CARe), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Box 440, 405 30, Göteborg, Sweden.
Center for Antibiotic Resistance Research (CARe), Department of Infectious Diseases, Institute of Biomedicine, Sahlgrenska Academy, University of Gothenburg, Gothenburg, Sweden, Box 440, 405 30, Göteborg, Sweden; Department of Clinical Microbiology, Sahlgrenska University Hospital, Gothenburg, Guldhedsgatan 10 A, 413 46, Göteborg, Sweden.
出版信息
Anaerobe. 2023 Jun;81:102738. doi: 10.1016/j.anaerobe.2023.102738. Epub 2023 May 20.
OBJECTIVE
The objectives were to determine the risk factors for recurrent healthcare facility-associated Clostridioides difficile infection (HCF-CDI) in a high CDI incidence, low antibiotic use setting and to determine if length of cefotaxime exposure is a risk factor for recurrent HCF-CDI.
METHODS
The risk factors for recurrent HCF-CDI were evaluated with a retrospective nested case control study based on chart reading. The risk factors were evaluated univariately and multivariately. Length of risk antibiotic exposure was evaluated further in a subanalysis.
RESULTS
Risk factors for recurrent HCF-CDI were renal insufficiency (25.4% of cases compared to 15.4% of controls p = 0.006) and metronidazole treatment of initial CDI episode (88.4% compared to 71.7% p = 0.01). Exposure to cefotaxime and risk for recurrent CDI showed a dose-dependent relationship (linear by linear p = 0.028).
CONCLUSIONS
Renal insufficiency and metronidazole treatment were independent risk factors for recurrent HCF-CDI in our setting. The relationship between cefotaxime exposure and risk for recurrent HCF-CDI, dose-dependent, could be evaluated further in a setting with high cefotaxime use.
目的
在高艰难梭菌感染（CDI）发生率、低抗生素使用环境中，确定复发性医疗机构相关艰难梭菌感染（HCF-CDI）的危险因素，并确定头孢噻肟暴露时间是否为复发性 HCF-CDI 的危险因素。
方法
通过基于图表阅读的回顾性巢式病例对照研究，评估复发性 HCF-CDI 的危险因素。对危险因素进行单因素和多因素分析。在亚分析中进一步评估风险抗生素暴露时间。
结果
复发性 HCF-CDI 的危险因素为肾功能不全（25.4%的病例与 15.4%的对照相比，p=0.006）和初始 CDI 发作时使用甲硝唑治疗（88.4%与 71.7%相比，p=0.01）。头孢噻肟暴露与 CDI 复发风险呈剂量依赖性关系（线性线性 p=0.028）。
结论
在我们的环境中，肾功能不全和甲硝唑治疗是复发性 HCF-CDI 的独立危险因素。头孢噻肟暴露与复发性 HCF-CDI 之间的关系呈剂量依赖性，在头孢噻肟使用较高的环境中可以进一步评估。
Zotero 插件