Iftimie Simona, López-Azcona Ana F, Corchero-Valverde Mireia, Peralta-Vázquez Antonio, López-Cordón Laia Revuelta, García-Cervera Carles, Fernández-Domínguez Luís Manuel, Camps Jordi, Joven Jorge, Castro Antoni
Department of Internal Medicine, Institut d'Investigació Sanitària Pere Virgili, Hospital Universitari de Sant Joan, Universitat Rovira i Virgili, 43204 Reus, Spain.
Laboratori de Referència Camp de Tarragona i Terres de l'Ebre, Hospital Universitari de Sant Joan, 43204 Reus, Spain.
J Clin Med. 2024 May 9;13(10):2799. doi: 10.3390/jcm13102799.
infections (CDI) vary in severity from mild diarrhea to life-threatening conditions like pseudomembranous colitis or toxic megacolon, often leading to sepsis and death. The COVID-19 pandemic prompted changes in healthcare practices, potentially affecting CDI incidence, though reported data are inconclusive. We studied factors influencing CDI incidence and outcomes at a university hospital throughout the COVID-19 pandemic years. We conducted a retrospective study on all adult hospitalized CDI cases from 1 January 2020 to 31 December 2022 in Hospital Universitari de Sant Joan in Reus. We collected demographic information, comorbid conditions, and concurrent infections. While overall CDI and COVID-19 rates decreased in 2022, a notable increase in CDI infections was observed among oncological patients and those undergoing some aggressive treatments, such as colonoscopies or gastroscopies. The prevalence of comorbidities remained unmodified, and there were declines in prior gastrointestinal surgeries and proton pump inhibitor prescriptions. Factors associated with patient fatality or prolonged hospitalization included older age, cancer, chronic kidney disease, higher Charlson and McCabe indices, elevated C-reactive protein, and low albumin concentrations. Our study shows the evolving landscape of CDI during the COVID-19 pandemic and emphasizes the impact of delayed diagnoses and treatments exacerbated by telemedicine adoption. Identified risk factors for CDI-related mortality or prolonged hospital stays underscore the importance of targeted interventions in high-risk populations.
艰难梭菌感染（CDI）的严重程度各不相同，从轻度腹泻到危及生命的状况，如假膜性结肠炎或中毒性巨结肠，常常导致败血症和死亡。新冠疫情促使医疗保健实践发生变化，这可能影响CDI的发病率，不过报告的数据尚无定论。我们研究了在整个新冠疫情期间，一所大学医院中影响CDI发病率和结局的因素。我们对2020年1月1日至2022年12月31日在雷乌斯的圣琼大学医院住院的所有成年CDI病例进行了一项回顾性研究。我们收集了人口统计学信息、合并症和并发感染情况。虽然2022年CDI和新冠的总体发病率有所下降，但在肿瘤患者以及接受某些侵袭性治疗（如结肠镜检查或胃镜检查）的患者中，观察到CDI感染显著增加。合并症的患病率保持不变，既往胃肠道手术和质子泵抑制剂处方有所减少。与患者死亡或住院时间延长相关的因素包括年龄较大、癌症、慢性肾病、较高的查尔森和麦凯布指数、C反应蛋白升高以及白蛋白浓度较低。我们的研究显示了新冠疫情期间CDI的变化情况，并强调了采用远程医疗加剧的延迟诊断和治疗的影响。确定的与CDI相关的死亡率或住院时间延长的风险因素凸显了对高危人群进行有针对性干预的重要性。
