≤45岁住院成人艰难梭菌（原梭状芽孢杆菌）感染的临床和微生物学特征：来自匈牙利的一项前瞻性观察队列研究
Clinical and Microbiological Characteristics of Hospitalized Adults Aged ≤ 45 Years With Clostridioides (Formerly Clostridium) difficile Infection: A Prospective Observational Cohort Study From Hungary.
作者信息
Petrik Borisz Rabán, Szabó Bálint Gergely, Laky Boglárka, Marosi Bence, Korózs Dorina, Lőrinczi Csaba, Fried Katalin, Lakatos Botond
机构信息
Károly Rácz Doctoral School of Clinical Medicine, Semmelweis University, Budapest, Hungary.
South Pest Central Hospital, National Institute of Hematology and Infectious Diseases, Budapest, Hungary.
出版信息
APMIS. 2025 May;133(5):e70028. doi: 10.1111/apm.70028.
Studies focusing on young adults with Clostridiodes (formerly Clostridium) difficile infection (CDI) are scarce. Our objective was to assess characteristics and outcomes of CDI among hospitalized young adults between the ages of 18-45 years at diagnosis, compared to a subcohort of randomly selected older patients aged > 45 years. We performed a prospective, observational cohort study by enrolling and stratifying 234 consecutive cases of first/recurrent CDI at our tertiary referral center between 2015 and 2019. At 30 days post-treatment initiation, young adults had a higher clinical cure (99.1% vs. 81.2%; p < 0.01) and lower all-cause mortality (0.9% vs. 16.4%; p < 0.01). Metronidazole was a common first-line choice (77.8% vs. 46.2%; p < 0.01) with similar relapse rates (6.0% vs. 5.1%, p = 0.56). We conclude that CDI in patients aged between 18 and 45 years was associated with fewer complications and higher clinical cure with metronidazole, compared to older patients.
针对艰难梭菌（原称梭状芽孢杆菌）感染（CDI）的年轻成年人的研究很少。我们的目的是评估确诊时年龄在18至45岁之间的住院年轻成年人中CDI的特征和结局，并与随机选择的45岁以上老年患者亚组进行比较。我们在2015年至2019年期间，在我们的三级转诊中心纳入并分层了234例连续的首次/复发性CDI病例，进行了一项前瞻性观察队列研究。在开始治疗后的30天，年轻成年人的临床治愈率更高（99.1%对81.2%；p<0.01），全因死亡率更低（0.9%对16.4%；p<0.01）。甲硝唑是常见的一线选择（77.8%对46.2%；p<0.01），复发率相似（6.0%对5.1%，p=0.56）。我们得出结论，与老年患者相比，18至45岁患者的CDI并发症更少，甲硝唑治疗的临床治愈率更高。
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