Arnar Thor Sigtryggsson, Kristjan Orri Helgason, Agnar Bjarnason, Magnus Gottfredsson
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引用次数: 0
Abstract
Objective: To investigate the epidemiology, severity, treatment, and prognosis of patients with C. difficile infections (CDI) diagnosed at Landspítali University Hospital from 2017-2022.
Materials and methods: The study population consisted of adult patients at Landspítali with double-positive (PCR + ELISA) diagnostic tests. If the same patient had two or more positive samples within a 28-day period, they were considered to reflect the same infection, and the latter samples were excluded.
Results: Overall, 358 CDI were identified in 301 patients. The majority of cases were diagnosed in women (59.5%). The incidence of healthcare-associated CDI was 3.23 infections/10.000 in-hospital days (range 2.65 - 3.26). Incidence of community-associated CDI was 0.57 infections/10.000 inhabitants of the Reykjavik metropolitan area. Incidence was positively correlated with increasing age and remained similar throughout the study period. The recurrence rate during the study period was 15.3% with a mean follow-up period of 1.6 person-years. At least 85.5% of patients had taken antibiotics within a month before diagnosis, most commonly from the penicillin class (57.8%), followed by cephalosporins (51.5%). More than half (54.7%) of patients had taken proton pump inhibitors preceding diagnosis. Metronidazole was the most common initial treatment (63.0%). Of these, 29.4% of cases required further treatment within 28 days of treatment start. Fecal microbiota transplantation was performed in 13 cases. The 30-day all-cause mortality rate was 7.3%.
Conclusions: The incidence of CDI at Landspítali has remained stable and comparable to what has been reported in Europe during the same period. Most patients had one or more risk factors present. Most received antibiotics as treatment, most commonly metronidazole. The results of this study indicate that incidence and clinical presentation of CDI in Iceland are stable, whilst novel treatment options look promising.
期刊介绍：
Læknablaðið er fræðirit sem birtir vísinda og yfirlitsgreinar og annað efni sem byggir á rannsóknum innan læknisfræði eða skyldra greina. Læknablaðið er gefið út af Læknafélagi Íslands. Blaðið er sent til allra félagsmanna. Það var fyrst gefið út árið 1904 en hefur komið samfellt út frá árinu 1915. Blaðið kemur út 11 sinnum á ári og er prentað í 2000 eintökum. Allt efni Læknablaðsins frá árinu 2000 er aðgengilegt á heimasíðu blaðsins á laeknabladid.is og er aðgangur endurgjaldslaus og öllum opinn.
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