Healthcare associated Clostridioides difficile infection in adult surgical and medical patients hospitalized in tertiary hospital in Belgrade, Serbia: a seven years prospective cohort study.

IF 16.4 1区 化学 Q1 CHEMISTRY, MULTIDISCIPLINARY
Vesna Šuljagić, Bojana Milenković, Aneta Perić, Dragutin Jovanović, Vesna Begović-Kuprešanin, Srđan Starčević, Aleksandar Tomić, Sandra Vezmar Kovačević, Viktorija Dragojević-Simić
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引用次数: 2

Abstract

Introduction: Clostridioides difficile (C. difficile) infection (CDI) is one of the most common healthcare-associated (HA) infections in contemporary medicine. The risk factors (RFs) for HA CDI in medical and surgical patients are poorly investigated in countries with a limited resource healthcare system. Therefore, the aim of the study was to investigate differences in patients' characteristics, factors related to healthcare and outcomes associated with HA CDI in surgical and medical patients in tertiary healthcare centre in Serbia.Materials and Methods: A prospective cohort study was conducted including adult patients diagnosed with initial episode of HA CDI, first recurrence of disease, readmission to hospital, while deaths within 30 days of CDI diagnosis and in-hospital mortality were also recorded. Patients hospitalized for any non-surgical illness, who developed initial HA CDI were assigned to medical group, whereas those who developed initial HA CDI after surgical procedures were in surgical group. The data on patients' characteristics and factors related to healthcare were collected, too.Results: During 7-year period, from 553 patients undergoing in-hospital treatment and diagnosed with CDI, 268 (48.5%) and 285 (51.5%) were surgical and medical patients, respectively. Age ≥ 65 years, use of proton pump inhibitors, chemotherapy and fluoroquinolones were positively associated with being in medical group, whereas admission to intensive care unit and use of second- and third-generation cephalosporins were positively associated with being in surgical group.Conclusions: Based on obtained results, including significant differences in 30-day mortality and in-hospital mortality, it can be concluded that medical patient were more endangered with HA CDI than surgical ones.

在塞尔维亚贝尔格莱德三级医院住院的成人外科和内科患者中与医疗保健相关的艰难梭菌感染:一项为期7年的前瞻性队列研究
艰难梭菌(C. difficile)感染(CDI)是当代医学中最常见的卫生保健相关(HA)感染之一。在医疗保健系统资源有限的国家,对内科和外科患者HA CDI的危险因素(RFs)调查甚少。因此,本研究的目的是调查塞尔维亚三级医疗中心外科和内科患者HA CDI的患者特征、与医疗保健相关的因素和结果的差异。材料与方法:本研究采用前瞻性队列研究,纳入确诊为HA CDI首发、疾病首次复发、再入院的成年患者,同时记录CDI诊断后30天内的死亡和住院死亡率。因非手术疾病住院的患者发生初始HA CDI被分配到内科组,而手术后发生初始HA CDI的患者被分配到外科组。收集了患者的特征和与医疗保健相关的因素的数据。结果:7年期间,553例住院诊断为CDI的患者中,手术患者268例(48.5%),内科患者285例(51.5%)。年龄≥65岁、使用质子泵抑制剂、化疗和氟喹诺酮类药物与内科组呈正相关,而入住重症监护病房和使用第二代和第三代头孢菌素与外科组呈正相关。结论:根据获得的结果,包括30天死亡率和住院死亡率的显著差异,可以得出内科患者比外科患者更容易发生HA CDI的结论。
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来源期刊
Accounts of Chemical Research
Accounts of Chemical Research 化学-化学综合
CiteScore
31.40
自引率
1.10%
发文量
312
审稿时长
2 months
期刊介绍: Accounts of Chemical Research presents short, concise and critical articles offering easy-to-read overviews of basic research and applications in all areas of chemistry and biochemistry. These short reviews focus on research from the author’s own laboratory and are designed to teach the reader about a research project. In addition, Accounts of Chemical Research publishes commentaries that give an informed opinion on a current research problem. Special Issues online are devoted to a single topic of unusual activity and significance. Accounts of Chemical Research replaces the traditional article abstract with an article "Conspectus." These entries synopsize the research affording the reader a closer look at the content and significance of an article. Through this provision of a more detailed description of the article contents, the Conspectus enhances the article's discoverability by search engines and the exposure for the research.
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