关于艰难梭菌的最新meta分析
Comorbidities, Exposure to Medications, and the Risk of Community-Acquired Clostridium difficile Infection: A Systematic Review and Meta-analysisLuis Furuya-Kanamoria1 c1, Jennifer C. Stonea2, Justin Clarka3, Samantha J. McKenziea2, Laith Yakoba4, David L. Patersona5, Thomas V. Rileya6, Suhail A. R. Doia2 and Archie C. Clementsa1
Abstract
Background Clostridium difficile infection (CDI) has been extensively described in healthcare settings; however, risk factors associated with community-acquired (CA) CDI remain uncertain. This study aimed to synthesize the current evidence for an association between commonly prescribed medications and comorbidities with CA-CDI.
Methods A systematic search was conducted in 5 electronic databases for epidemiologic studies that examined the association between the presence of comorbidities and exposure to medications with the risk of CA-CDI. Pooled odds ratios were estimated using 3 meta-analytic methods. Subgroup analyses by location of studies and by life stages were conducted.
Results Twelve publications (n=56,776 patients) met inclusion criteria. Antimicrobial (odds ratio, 6.18; 95% CI, 3.80–10.04) and corticosteroid (1.81; 1.15–2.84) exposure were associated with increased risk of CA-CDI. Among the comorbidities, inflammatory bowel disease (odds ratio, 3.72; 95% CI, 1.52–9.12), renal failure (2.64; 1.23–5.68), hematologic cancer (1.75; 1.02–5.68), and diabetes mellitus (1.15; 1.05–1.27) were associated with CA-CDI. By location, antimicrobial exposure was associated with a higher risk of CA-CDI in the United States, whereas proton-pump inhibitor exposure was associated with a higher risk in Europe. By life stages, the risk of CA-CDI associated with antimicrobial exposure greatly increased in adults older than 65 years.
Conclusions Antimicrobial exposure was the strongest risk factor associated with CA-CDI. Further studies are required to investigate the risk of CA-CDI associated with medications commonly prescribed in the community. Patients with diarrhea who have inflammatory bowel disease, renal failure, hematologic cancer, or diabetes are appropriate populations for interventional studies of screening.
全文链接：http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=9541513&fulltextType=RA&fileId=S0899823X14000397 Clostridium difficile infection (CDI) 是非常热的一个研究热点，建议大家多多关注。 CA-CDI，社区艰难梭菌腹泻，比较新的报告。 可能能力有限，有些专业词汇没看懂，哪位专业人士能翻译成中文就好了！ 谢谢老师的资料，要是中文就更好了。
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