Clostridium difficile Infection in Children: Epidemiology and Trend in a Swedish Tertiary Care Hospital
Clostridium difficile Infection in Children: Epidemiology and Trend in a Swedish Tertiary Care Hospital
复制标题
DOI：
10.1097/inf.0000000000002480
复制
发表时间：
2019-12-01
影响因子：
3.6
通讯作者：
Nilsson, Anna
中科院分区：
文献类型：
--
作者：
Malmqvist, Lovisa;Ullberg, Mans;Nilsson, Anna
背景：几项研究表明，儿童艰难梭菌感染（CDI）呈上升趋势。然而，瑞典公共卫生署报告说，自2007年以来，瑞典人口中的CDI发病率有所下降。本研究的主要目的是分析儿童CDI的流行病学。方法：回顾性图表审查患者1至= 2周，8周前发作）。新发事件被分类为医院相关（HA-CDI）或社区相关（CA-CDI）。计算了集水区每100 000名儿童的年感染率。结果如下：206例患者中有328例阳性，其中259例（79.0%）为新发，69例（21.0%）为复发。在63/206例（30.6%）儿童中，记录了>1次CDI发作。平均感染率为8.5/10万儿童。2010年7月至2018年6月，CDI率总体呈上升趋势，但无统计学显著性（P = 0.061），HA-CDI（P = 0.720）或CA-CDI（P = 0.179）的发生率也无统计学显著性。226/259例（87.3%）新发事件中存在基础医学疾病，其中最常见的是恶性肿瘤。在新发事件中，188/259（72.6%）例为HA-CDI，46/259（17.8%）例为CA-CDI。结论：从2010年到2018年，瑞典儿童的CDI呈上升趋势，尽管没有统计学意义。CDI与合并症相关，反复发作很常见。
Background: Several studies have shown an increasing trend in pediatric Clostridium difficile infection (CDI). However, the Public Health Agency in Sweden reports a decreasing incidence of CDI in the Swedish population since 2007. The main aim of this study is to analyze the epidemiology of CDI in children. Methods: Retrospective chart-review of patients 1 to = 2 weeks, 8 weeks from previous episode). New episodes were classified as hospital- (HA-CDI) or community-associated (CA-CDI). Annual infection rates/100,000 children in the catchment area were calculated. Results: Three hundred twenty-eight positive tests in 206 patients were included of which 259 (79.0%) tests were new episodes and 69 (21.0%) recurrences. In 63/206 (30.6%) children, >1 episode of CDI was recorded. The mean infection rate was 8.5/100,000 children. There was an overall increasing trend in CDI-rate July 2010-June 2018, however not statistically significant (P = 0.061) nor for the incidence in HA-CDI (P = 0.720) or CA-CDI (P = 0.179). Underlying medical conditions were present in 226/259 (87.3%) new episodes of which the most common was malignancy. Of the new episodes, 188/259 (72.6%) were HA-CDI and 46/259 (17.8%) were CA-CDI. Conclusions: There was an increasing trend in CDI in children in Sweden from 2010 to 2018, although not statistically significant. CDI was associated with comorbid conditions and repeated episodes were common.