Depression, antidepressant medications, and risk of Clostridium difficile infection.
Depression, antidepressant medications, and risk of Clostridium difficile infection.
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DOI：
10.1186/1741-7015-11-121
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发表时间：
2013-05-07
期刊：
影响因子：
9.3
通讯作者：
Aronoff DM
中科院分区：
文献类型：
--
作者：
Rogers MA;Greene MT;Young VB;Saint S;Langa KM;Kao JY;Aronoff DM
先前研究的一项辅助发现表明，使用抗抑郁药物会增加发生艰难梭菌感染（CDI）的风险。我们的目的是评估抑郁症或使用抗抑郁药是否会改变发生CDI的风险，使用两个不同的数据集和研究设计。在研究1中，我们对具有全国代表性的美国老年人样本（n = 16，781）进行了纵向调查，将两年一次的访谈数据与医生和急诊科就诊、住院和专业护理设施、家庭健康访视和其他门诊访视联系起来。在研究2中，我们完成了一项对住院成人进行C。艰难梭菌（n = 4047），病例检测为阳性，对照检测为阴性。确定了试验前使用的抗真菌药物。在美国老年人中，抑郁症患者的CDI基于人群的发生率为282.9/100，000人-年（95%置信区间（CI）为226.3至339.5），而无抑郁症患者的CDI发生率为197.1/100，000人-年（95% CI为168.0至226.1）。重度抑郁症患者发生CDI的几率高出36（95% CI 1.06 - 1.74），抑郁症患者高35%（95% CI 1.05至1.73），丧偶者高54%（95% CI 1.21至1.95），非独居成年人降低25%（95% CI 0.62至0.92）。基线时自我报告感到悲伤或有情绪、神经或精神问题也与CDI的后期发展相关。住院期间使用某些抗抑郁药物与CDI风险改变相关。患有抑郁症的成年人和服用特定抗抑郁药的人似乎更有可能患上CDI。丧偶或独居的老年人患CDI的风险也更大。
An ancillary finding in previous research has suggested that the use of antidepressant medications increases the risk of developing Clostridium difficile infection (CDI). Our objective was to evaluate whether depression or the use of anti-depressants altered the risk of developing CDI, using two distinct datasets and study designs. In Study 1, we conducted a longitudinal investigation of a nationally representative sample of older Americans (n = 16,781), linking data from biennial interviews to physician and emergency department visits, stays in hospital and skilled nursing facilities, home health visits, and other outpatient visits. In Study 2, we completed a clinical investigation of hospitalized adults who were tested for C. difficile (n = 4047), with cases testing positive and controls testing negative. Antidepressant medication use prior to testing was ascertained. The population-based rate of CDI in older Americans was 282.9/100,000 person-years (95% confidence interval (CI)) 226.3 to 339.5) for individuals with depression and 197.1/100,000 person-years for those without depression (95% CI 168.0 to 226.1). The odds of CDI were 36% greater in persons with major depression (95% CI 1.06 to 1.74), 35% greater in individuals with depressive disorders (95% CI 1.05 to 1.73), 54% greater in those who were widowed (95% CI 1.21 to 1.95), and 25% lower in adults who did not live alone (95% CI 0.62 to 0.92). Self-reports of feeling sad or having emotional, nervous or psychiatric problems at baseline were also associated with the later development of CDI. Use of certain antidepressant medications during hospitalization was associated with altered risk of CDI. Adults with depression and who take specific anti-depressants seem to be more likely to develop CDI. Older adults who are widowed or who live alone are also at greater risk of CDI.
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