艰难梭菌与季节性流感关系的时间序列分析（翻译有奖）

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A Time-Series Analysis of Clostridium difficile and Its Seasonal Association with Influenza

Infect Control Hosp Epidemiol 2010;31:382–387
Objective.To characterize the temporal progression of the monthly incidence of Clostridium difficile infections (CDIs) and to determine whether the incidence of CDI is related to the incidence of seasonal influenza.

Design.A retrospective study of patients in the Nationwide Inpatient Sample during the period from 1998 through 2005.

Methods.We identified all hospitalizations with a primary or secondary diagnosis of CDI with use of International Classification of Diseases, 9th Revision, Clinical Modification codes, and we did the same for influenza. The incidence of CDI was modeled as an autoregression about a linear trend. To investigate the association of CDI with influenza, we compared national and regional CDI and influenza series data and calculated cross-correlation functions with data that had been prewhitened (filtered to remove temporal patterns common to both series). To estimate the burden of seasonal CDI, we developed a proportional measure of seasonal CDI.

Results.Time-series analysis of the monthly number of CDI cases reveals a distinct positive linear trend and a clear pattern of seasonal variation ( ). The cross-correlation functions indicate that influenza activity precedes CDI activity on both a national and regional basis. The average burden of seasonal (ie, winter) CDI is 23%.

Conclusions.The epidemiologic characteristics of CDI follow a pattern that is seasonal and associated with influenza, which is likely due to antimicrobial use during influenza seasons. Approximately 23% of average monthly CDI during the peak 3 winter months could be eliminated if CDI remained at summer levels.

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这个研究比较有趣，艰难梭菌与流感之间也有联系，就是流感期间抗生素的使用增加了艰难梭菌感染率。

wjllulu

水平有限，参与的积极性无限——先自我表扬一下。

目标：1、描述CDI月发病率的时间数列特点；2、探讨CDI发病率与季节性流感的关联性。设计：对1998年至2005年期间全国范围内住院患者的回顾性研究。方法：选取所有第一或第二临床确诊（根据国际临床疾病分类编码第9版内容）为CDI和流感的患者，以CDI发病率做一线性趋势的自回归模型分析。对探讨CDI与流感的关联，我们对来自全国范围内和地区性的CDI和流感发病率系列数据进行了比较，对筛选出的双方趋同形态的数据进行交叉关联函数计算。然后评估季节性CDI的负载量，从而形成季节性CDI发病率比率计算方方式。结果：对CDI月发病率时间系列分析显示，其明显具有的正线性趋势和清晰的季节性变异现象。而CDI和流感的交叉关联函数显示，无论在全国范围内还是区域性都是流感发生先于CDI发生的情况。平均CDI季节性发病率的增加载量（我的理解——在某一点为基线的发病率的基础上所增加的发病率）为23%。结论：CDI的流行病学特点具有季节性，它与流感相关联。这一情况很可能的原因为流感期间使用抗生素药物的影响。（可以这样认为）如果保持CDI夏季月发病率（基线发病率）的话，在流感季节高峰的（冬季）3个月期间，将有23%的CDI可以消除。

wjllulu

潮水版主的奖分为何缩水了？呜……

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回复 4# wjllulu
呵呵！最近论坛在调整加分规则，翻译有奖不在此列，给你补上！