Clinical and demographic profile and risk factors for Clostridium difficile infection
Clinical and demographic profile and risk factors for Clostridium difficile infection
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DOI：
10.7705/biomedica.v37i1.2915
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发表时间：
2017-01-01
期刊：
影响因子：
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通讯作者：
Jaimes, Fabián
中科院分区：
文献类型：
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作者：
Carvajal, Carlos;Pacheco, Carlos;Jaimes, Fabián
前言：艰难梭菌感染是医院感染性腹泻的主要原因。随着发病率的增加，对初始治疗的反应率降低，复发率升高，从而增加了疾病的负担。目的：了解住院的C.材料和方法：我们进行了一项巢式病例队列研究。我们回顾了医院内腹泻患者的病历，这些患者进行了毒素A-B或C的测定。从2010年2月至2012年2月，已要求使用difficile。我们将病例定义为腹泻和毒素检测阳性的患者，对照定义为毒素检测阴性的患者。我们收集了人口统计学和临床特征，危险因素，住院时间，治疗和并发症的数据。结果：我们收集了123例患者在随访期间，其中30人是阳性毒素的数据。研究人群的平均年龄为49岁，60%为男性。主要症状为腹痛（35%）和发热（34%）。主要并发症为电解质改变和严重脓毒症，继发急性肾损伤。死亡率为13%，与感染外观相关的独立因素是质子泵抑制剂的使用和既往胃肠道手术史。艰难感染
Introduction: Clostridium difficile infection is the leading cause of nosocomial infectious diarrhea. The increasing incidence added to a lower rate of response to the initial treatment and higher rates of relapse has generated a higher burden of the disease.Objective: To determine the clinical characteristics of hospitalized patients with C. difficile infection.Materials and methods: We made a nested case-cohort study. We reviewed medical records of the patients with nosocomial diarrhea for whom an assay for toxin A-B of C. difficile had been requested from February, 2010, to February, 2012. We defined case as a patient with diarrhea and a positive assay for the toxin, and control as those patients with a negative assay for the toxin. We collected data on demographic and clinical characteristics, risk factors, hospital length of stay, treatment, and complications.Results: We collected data from 123 patients during the follow-up period, 30 of whom were positive for the toxin. Mean age in the study population was 49 years and 60% were men. The main symptoms were abdominal pain (35%) and fever (34%). The principal complications were electrolytic alteration and severe sepsis with secondary acute kidney injury. Mortality was 13% and independent factors associated to the appearance of the infection were the use of proton pump inhibitors and previous gastrointestinal tract surgery.Conclusions: The use of proton pump inhibitors and previous gastrointestinal tract surgery were factors associated to C. difficile infection.