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肿瘤患者感染的晚期不良结局:一项多中心队列研究。

Late poor outcomes of infections in oncological patients: A multicentre cohort study.

作者信息

Calbo Esther, Hernández Sergi, Sopena Nieves, Castellá Laia, Lopez-Contreras Joaquín, Cuquet Jordi, López-Sánchez Maria, Pérez Rafel, Gudiol Carlota, Coloma Ana, Marimón Mariló, Espinach Joan, Andres Marta, Martos Purificación, Carvalho Rodrigues Gonçalo, Limón Enric

机构信息

Infectious Diseases Unit, Department of Internal Medicine, Hospital Universitari Mútua Terrassa, Barcelona, Spain.

Universitat Internacional de Catalunya, Barcelona, Spain.

出版信息

J Infect Prev. 2023 Jul;24(4):182-186. doi: 10.1177/17571774231165410. Epub 2023 Mar 21.

Abstract

BACKGROUND

Cancer has been associated with an increased risk of in-hospital mortality in CDI patients. However, data on delayed mortality in cancer patients with CDI are scarce.

AIM/OBJECTIVE: The aim of the present study was to compare outcomes between oncological patients and the general population with infection (CDI) after 90 days of follow-up.

METHODS

A multicenter prospective cohort study was conducted in 28 hospitals participating in the VINCat program. Cases were all consecutive adult patients who met the case definition of CDI. Sociodemographic, clinical, and epidemiological variables and evolution at discharge and after 90 days were recorded for each case.

FINDINGS/RESULTS: The mortality rate was higher in oncological patients (OR = 1.70, 95% CI: 1.08-2.67). In addition, oncological patients receiving chemotherapy (CT) presented higher recurrence rates (18.5% vs 9.8%, = 0.049). Among oncological patients treated with metronidazole, those with active CT showed a higher rate of recurrence (35.3% vs 8.0% = 0.04).

DISCUSSION

Oncological patients presented a higher risk of poor outcomes after CDI. Their early and late mortality rates were higher than in the general population, and in parallel, those undergoing chemotherapy (especially those receiving metronidazole) had higher rates of recurrence.

摘要

背景

癌症与艰难梭菌感染(CDI)患者的院内死亡风险增加有关。然而,关于CDI癌症患者延迟死亡的数据很少。

目的

本研究的目的是比较肿瘤患者与一般人群在随访90天后发生CDI的结局。

方法

在参与VINCat项目的28家医院进行了一项多中心前瞻性队列研究。病例为所有符合CDI病例定义的连续成年患者。记录每个病例的社会人口统计学、临床和流行病学变量以及出院时和90天后的病情演变。

结果

肿瘤患者的死亡率更高(OR = 1.70,95%CI:1.08 - 2.67)。此外,接受化疗(CT)的肿瘤患者复发率更高(18.5%对9.8%,P = 0.049)。在接受甲硝唑治疗的肿瘤患者中,正在进行CT治疗的患者复发率更高(35.3%对8.0%,P = 0.04)。

讨论

肿瘤患者发生CDI后预后不良的风险更高。他们的早期和晚期死亡率高于一般人群,同时,接受化疗的患者(尤其是接受甲硝唑治疗的患者)复发率更高。

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