Prevalence of Clostridium difficile Infection among Solid Organ Transplant Recipients: A Meta-Analysis of Published Studies
Prevalence of Clostridium difficile Infection among Solid Organ Transplant Recipients: A Meta-Analysis of Published Studies
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DOI：
10.1371/journal.pone.0124483
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发表时间：
2015-04-17
期刊：
影响因子：
3.7
通讯作者：
Mylonakis, Eleftherios
中科院分区：
文献类型：
--
作者：
Paudel, Suresh;Zacharioudakis, Ioannis M.;Mylonakis, Eleftherios
包括使用抗生素，免疫抑制和频繁住院的几个因素使固体器官移植（SOT）受体很容易受到艰难梭菌感染（CDI）的影响。我们从1991 - 2014年对已发表的研究进行了荟萃分析，以估算该患者人群中CDI的患病率。我们搜索了PubMed，Embase和Google Scholar数据库。在75,940个检索引用中，我们发现了30项与我们研究相关的35篇文章编码的研究。基于这些研究，我们估计了21,683例接受肾脏，肝脏，肺，心脏，心脏，胰腺，肠，肠或多个器官的患者中CDI的普遍性，并根据移植器官的类型，研究传导的位置和患者人群的大小根据移植器官进行了分层。 SOT接受者的总体估计患病率为7.4％[95％CI，（5.6-9.5％）]，并且根据器官移植的类型而变化。在接受多个器官移植的患者中，患病率为12.7％[95％CI，（6.4％-20.9％）]。 The prevalence among other SOT recipients was: lung 10.8% [95% CI, (5.5%-17.7%)], liver 9.1 % [95% CI, (5.8%-13.2%)], intestine 8% [95% CI, (2.6%-15.9%)], heart 5.2% [95% CI, (1.8%-10.2%)], kidney 4.7% [95% CI，（2.6％-7.3％）]和胰腺3.2％[95％CI，（0.5％-7.9％）]。在报告相关数据的研究中，严重CDI的估计患病率为5.3％[95％CI（2.3％-9.3％）]，总复发率为19.7％[95％CI，（13.7％-26.6％）]。总而言之，CDI是SOT后的重要并发症，预防策略对于降低CDI相关的发病率和死亡率很重要。
Several factors including antibiotic use, immunosuppression and frequent hospitalizations make solid organ transplant (SOT) recipients vulnerable to Clostridium difficile infection (CDI). We conducted a meta-analysis of published studies from 1991-2014 to estimate the prevalence of CDI in this patient population. We searched PubMed, EMBASE and Google Scholar databases. Among the 75,940 retrieved citations, we found 30 studies coded from 35 articles that were relevant to our study. Based on these studies, we estimated the prevalence of CDI among 21,683 patients who underwent transplantation of kidney, liver, lungs, heart, pancreas, intestine or more than one organ and stratified each study based on the type of transplanted organ, place of the study conduction, and size of patient population. The overall estimated prevalence in SOT recipients was 7.4% [95% CI, (5.6-9.5%)] and it varied based on the type of organ transplant. The prevalence was 12.7%[95% CI, (6.4%-20.9%)] among patients who underwent transplantation for more than one organ. The prevalence among other SOT recipients was: lung 10.8% [95% CI, (5.5%-17.7%)], liver 9.1 % [95% CI, (5.8%-13.2%)], intestine 8% [95% CI, (2.6%-15.9%)], heart 5.2% [95% CI, (1.8%-10.2%)], kidney 4.7% [95% CI, (2.6%-7.3%)], and pancreas 3.2% [95% CI, (0.5%-7.9%)]. Among the studies that reported relevant data, the estimated prevalence of severe CDI was 5.3% [95% CI (2.3%-9.3%)] and the overall recurrence rate was 19.7% [95% CI, (13.7%-26.6%)]. In summary, CDI is a significant complication after SOT and preventive strategies are important in order to reduce the CDI related morbidity and mortality.