Interaction of Clostridioides difficile infection with frailty and cognition in the elderly: a narrative review.
Interaction of Clostridioides difficile infection with frailty and cognition in the elderly: a narrative review.
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DOI：
10.1186/s40001-023-01432-9
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发表时间：
2023-10-17
影响因子：
4.2
通讯作者：
Warren, Cirle A.
中科院分区：
文献类型：
--
作者：
Fernandez-Cotarelo, Maria-Jose;Jackson-Akers, Jasmine Y.;Nagy-Agren, Stephanie E.;Warren, Cirle A.
艰难梭菌感染（CDI）是疟疾相关腹泻和医疗保健相关感染的主要原因，尤其影响老年患者及其全球健康。这篇综述更新了对这种感染的理解，重点是认知障碍和虚弱作为CDI的危险因素和后果，总结了最近的知识和这种相互作用的潜在机制。进行了文献检索，包括将认知和功能障碍、衰老、生活质量、发病率和死亡率与CDI、微生物组和肠-脑轴合并的术语。高龄仍然是CDI中严重疾病、复发和死亡的关键风险。观察和生活质量的研究表明，老年人急性CDI后功能丧失的证据。反过来，虚弱和认知障碍是CDI后死亡的独立预测因素。CDI对老年人有长期影响，导致再入院和死亡的风险增加，即使在急性事件发生后几个月。免疫衰老和老化微生物群是对CDI易感性的关键，其中包括炎症和暴露于管腔微生物产物在内的因素在肠-脑轴中发挥作用。虚弱和健康状况差是老年人CDI的危险因素。CDI影响生活质量、认知和功能，导致患者健康状况随时间推移而下降，并导致早期和晚期死亡。证据的叙述性合成提出了一个框架，用于观察CDI老年人功能和认知下降的周期，影响肠-脑和肠-肌肉轴。
Clostridioides difficile infection (CDI) is the leading cause of antibiotic-related diarrhea and healthcare-associated infections, affecting in particular elderly patients and their global health. This review updates the understanding of this infection, with focus on cognitive impairment and frailty as both risk factors and consequence of CDI, summarizing recent knowledge and potential mechanisms to this interplay. A literature search was conducted including terms that would incorporate cognitive and functional impairment, aging, quality of life, morbidity and mortality with CDI, microbiome and the gut–brain axis. Advanced age remains a critical risk for severe disease, recurrence, and mortality in CDI. Observational and quality of life studies show evidence of functional loss in older people after acute CDI. In turn, frailty and cognitive impairment are independent predictors of death following CDI. CDI has long-term impact in the elderly, leading to increased risk of readmissions and mortality even months after the acute event. Immune senescence and the aging microbiota are key in susceptibility to CDI, with factors including inflammation and exposure to luminal microbial products playing a role in the gut–brain axis. Frailty and poor health status are risk factors for CDI in the elderly. CDI affects quality of life, cognition and functionality, contributing to a decline in patient health over time and leading to early and late mortality. Narrative synthesis of the evidence suggests a framework for viewing the cycle of functional and cognitive decline in the elderly with CDI, impacting the gut–brain and gut–muscle axes.
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影响因子：
3.7
作者：
Biagi E;Nylund L;Candela M;Ostan R;Bucci L;Pini E;Nikkïla J;Monti D;Satokari R;Franceschi C;Brigidi P;De Vos W
通讯作者：
De Vos W
影响因子：
3.7
作者：
Finn E;Andersson FL;Madin-Warburton M
通讯作者：
Madin-Warburton M
美国梭菌艰难梭菌感染和结果负担的趋势。
DOI：
10.1056/nejmoa1910215
发表时间：
2020-04-02
期刊：
The New England journal of medicine
影响因子：
--
作者：
Guh AY;Mu Y;Winston LG;Johnston H;Olson D;Farley MM;Wilson LE;Holzbauer SM;Phipps EC;Dumyati GK;Beldavs ZG;Kainer MA;Karlsson M;Gerding DN;McDonald LC;Emerging Infections Program Clostridioides difficile Infection Working Group
通讯作者：
Emerging Infections Program Clostridioides difficile Infection Working Group
DOI：
10.3390/antibiotics10030299
发表时间：
2021-03-13
期刊：
Antibiotics (Basel, Switzerland)
影响因子：
--
作者：
Czepiel J;Krutova M;Mizrahi A;Khanafer N;Enoch DA;Patyi M;Deptuła A;Agodi A;Nuvials X;Pituch H;Wójcik-Bugajska M;Filipczak-Bryniarska I;Brzozowski B;Krzanowski M;Konturek K;Fedewicz M;Michalak M;Monpierre L;Vanhems P;Gouliouris T;Jurczyszyn A;Goldman-Mazur S;Wultańska D;Kuijper EJ;Skupień J;Biesiada G;Garlicki A
通讯作者：
Garlicki A
影响因子：
5.7
作者：
Girard, Timothy D.;Self, Wesley H.;Jackson, James C.
通讯作者：
Jackson, James C.