Opioid use and risk of Clostridioides difficile infection in hospitalized patients: A systematic review and meta-analysis.

IF 3.8 3区医学 Q2 INFECTIOUS DISEASES

American journal of infection control Pub Date : 2025-06-26 DOI:10.1016/j.ajic.2025.06.019

Pooja Gokhale, Lorenzo Villa Zapata

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引用次数: 0

Abstract

Background: Clostridioides difficile infection (CDI) is a leading cause of nosocomial infections, particularly in immunocompromised individuals. Evidence suggests that opioid use may increase the risk of CDI in hospitalized patients. This systematic review and meta-analysis aims to assess the association between opioid use and CDI among hospitalized patients.

Methods: A comprehensive literature search was conducted from inception to January 2024 across PubMed/MEDLINE, Web of Science, and the Cochrane Library. The search was supplemented by hand-searching reference lists of included articles. Observational studies comparing adult opioid users with nonusers in a hospital setting were included. The meta-analysis employed a restricted maximum likelihood random-effects model using R Statistical Software, version 4.3.2.

Results: From 1,521 articles initially retrieved, 4 met the inclusion criteria, comprising 119,145 patients. Of these, 42,794 were opioid users, and 76,351 were nonusers. There were 13,399 cases of CDI among opioid users, compared with 13,184 among nonusers. The meta-analysis revealed an odds ratio of 1.98 (95% confidence interval: 1.54-2.56), indicating a significantly higher risk of CDI in opioid users.

Conclusions: The findings underscore the need for further research to explore the impact of opioid use on the severity of CDI.

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住院患者阿片类药物的使用和艰难梭菌感染的风险：系统回顾和荟萃分析。

目的：艰难梭菌感染（CDI）是医院感染的主要原因，特别是在免疫功能低下的个体中。新出现的证据表明，阿片类药物的使用可能会增加住院患者CDI的风险。本系统综述和荟萃分析的目的是评估住院患者阿片类药物使用与CDI之间的关系。方法：对PubMed/MEDLINE、Web of Science和Cochrane图书馆从成立到2024年1月进行了全面的文献检索。通过手工检索纳入文章的参考书目来补充检索。在医院环境中，比较成人阿片类药物使用者和非使用者的观察性研究包括在内。meta分析采用限制性最大似然（REML）随机效应模型，采用R统计软件4.3.2版本。结果：在最初检索的1521篇文章中，有4篇符合纳入标准，共119,145例患者。其中，42,794人是阿片类药物使用者，76,351人是非阿片类药物使用者。阿片类药物使用者中有13399例CDI，而非阿片类药物使用者中有13184例。荟萃分析显示，比值比（OR）为1.98 (95% CI: 1.54-2.56)，表明阿片类药物使用者发生CDI的风险明显更高。结论：这些发现强调了进一步研究阿片类药物使用对CDI严重程度的影响的必要性。临床医生应考虑阿片类药物的替代品或加强监测策略，以减轻弱势人群，特别是老年人和免疫功能低下人群的感染风险。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

American journal of infection control 医学-传染病学

CiteScore

7.40

自引率

4.10%

发文量

479

审稿时长

24 days

期刊介绍： AJIC covers key topics and issues in infection control and epidemiology. Infection control professionals, including physicians, nurses, and epidemiologists, rely on AJIC for peer-reviewed articles covering clinical topics as well as original research. As the official publication of the Association for Professionals in Infection Control and Epidemiology (APIC)