J.W. Suh , Y.J. Jeong , H.G. Ahn , J.Y. Kim , J.W. Sohn , Y.K. Yoon
{"title":"大韩民国活动性肺结核患者中艰难梭菌感染的流行病学特征和风险因素：一项基于全国人口的研究。","authors":"J.W. Suh , Y.J. Jeong , H.G. Ahn , J.Y. Kim , J.W. Sohn , Y.K. Yoon","doi":"10.1016/j.jhin.2024.07.019","DOIUrl":null,"url":null,"abstract":"<div><h3>Background</h3><div>The relationship between anti-tuberculosis (TB) agents and <em>Clostridioides difficile</em> infection (CDI) remains unclear. This study aimed to investigate the epidemiological characteristics and risk factors for CDI in patients with TB.</div></div><div><h3>Methods</h3><div>This nationwide, population-based cohort study was conducted in the Republic of Korea (ROK) between January 2018 and December 2022. Data were extracted from the National Health Insurance Service-National Health Information Database. The risk factors for CDI in patients with TB were identified through multi-variate logistic regression analysis using a 1:4 greedy matching method based on age and sex.</div></div><div><h3>Results</h3><div>During the study period, CDI developed in 2901 of the 131,950 patients with TB who were prescribed anti-TB agents. The incidence of CDI in patients with TB has increased annually in the ROK from 12.31/1000 in 2018 to 33.51/1000 in 2022. Oral metronidazole (81.94%) was the most common first-line treatment for CDI. The in-hospital mortality rate of patients with concomitant CDI and TB was 9.9%, compared with 6.9% in those with TB alone (<em>P</em><0.0001). Multi-variate logistic regression analysis found intensive care unit admission, Charlson Comorbidity Index ≥3, antibiotic exposure, standard regimen, multi-drug-resistant TB and extrapulmonary TB to be significant risk factors for development of CDI in patients with TB.</div></div><div><h3>Conclusion</h3><div>CDI is uncommon in patients with TB, but it results in a significantly increased mortality rate. Patients being treated for TB should be monitored carefully for the development of CDI. Further clinical research is warranted to identify effective interventions for preventing and controlling CDI during TB treatment.</div></div>","PeriodicalId":54806,"journal":{"name":"Journal of Hospital Infection","volume":"154 ","pages":"Pages 1-8"},"PeriodicalIF":3.9000,"publicationDate":"2024-09-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Epidemiologic characteristics and risk factors of Clostridioides difficile infection in patients with active tuberculosis in the Republic of Korea: a nationwide population-based study\",\"authors\":\"J.W. Suh , Y.J. Jeong , H.G. Ahn , J.Y. Kim , J.W. Sohn , Y.K. Yoon\",\"doi\":\"10.1016/j.jhin.2024.07.019\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<div><h3>Background</h3><div>The relationship between anti-tuberculosis (TB) agents and <em>Clostridioides difficile</em> infection (CDI) remains unclear. This study aimed to investigate the epidemiological characteristics and risk factors for CDI in patients with TB.</div></div><div><h3>Methods</h3><div>This nationwide, population-based cohort study was conducted in the Republic of Korea (ROK) between January 2018 and December 2022. Data were extracted from the National Health Insurance Service-National Health Information Database. The risk factors for CDI in patients with TB were identified through multi-variate logistic regression analysis using a 1:4 greedy matching method based on age and sex.</div></div><div><h3>Results</h3><div>During the study period, CDI developed in 2901 of the 131,950 patients with TB who were prescribed anti-TB agents. The incidence of CDI in patients with TB has increased annually in the ROK from 12.31/1000 in 2018 to 33.51/1000 in 2022. Oral metronidazole (81.94%) was the most common first-line treatment for CDI. The in-hospital mortality rate of patients with concomitant CDI and TB was 9.9%, compared with 6.9% in those with TB alone (<em>P</em><0.0001). Multi-variate logistic regression analysis found intensive care unit admission, Charlson Comorbidity Index ≥3, antibiotic exposure, standard regimen, multi-drug-resistant TB and extrapulmonary TB to be significant risk factors for development of CDI in patients with TB.</div></div><div><h3>Conclusion</h3><div>CDI is uncommon in patients with TB, but it results in a significantly increased mortality rate. Patients being treated for TB should be monitored carefully for the development of CDI. Further clinical research is warranted to identify effective interventions for preventing and controlling CDI during TB treatment.</div></div>\",\"PeriodicalId\":54806,\"journal\":{\"name\":\"Journal of Hospital Infection\",\"volume\":\"154 \",\"pages\":\"Pages 1-8\"},\"PeriodicalIF\":3.9000,\"publicationDate\":\"2024-09-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Hospital Infection\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://www.sciencedirect.com/science/article/pii/S0195670124002998\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q1\",\"JCRName\":\"INFECTIOUS DISEASES\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Hospital Infection","FirstCategoryId":"3","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S0195670124002998","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q1","JCRName":"INFECTIOUS DISEASES","Score":null,"Total":0}
Epidemiologic characteristics and risk factors of Clostridioides difficile infection in patients with active tuberculosis in the Republic of Korea: a nationwide population-based study
Background
The relationship between anti-tuberculosis (TB) agents and Clostridioides difficile infection (CDI) remains unclear. This study aimed to investigate the epidemiological characteristics and risk factors for CDI in patients with TB.
Methods
This nationwide, population-based cohort study was conducted in the Republic of Korea (ROK) between January 2018 and December 2022. Data were extracted from the National Health Insurance Service-National Health Information Database. The risk factors for CDI in patients with TB were identified through multi-variate logistic regression analysis using a 1:4 greedy matching method based on age and sex.
Results
During the study period, CDI developed in 2901 of the 131,950 patients with TB who were prescribed anti-TB agents. The incidence of CDI in patients with TB has increased annually in the ROK from 12.31/1000 in 2018 to 33.51/1000 in 2022. Oral metronidazole (81.94%) was the most common first-line treatment for CDI. The in-hospital mortality rate of patients with concomitant CDI and TB was 9.9%, compared with 6.9% in those with TB alone (P<0.0001). Multi-variate logistic regression analysis found intensive care unit admission, Charlson Comorbidity Index ≥3, antibiotic exposure, standard regimen, multi-drug-resistant TB and extrapulmonary TB to be significant risk factors for development of CDI in patients with TB.
Conclusion
CDI is uncommon in patients with TB, but it results in a significantly increased mortality rate. Patients being treated for TB should be monitored carefully for the development of CDI. Further clinical research is warranted to identify effective interventions for preventing and controlling CDI during TB treatment.
期刊介绍：
The Journal of Hospital Infection is the editorially independent scientific publication of the Healthcare Infection Society. The aim of the Journal is to publish high quality research and information relating to infection prevention and control that is relevant to an international audience.
The Journal welcomes submissions that relate to all aspects of infection prevention and control in healthcare settings. This includes submissions that:
provide new insight into the epidemiology, surveillance, or prevention and control of healthcare-associated infections and antimicrobial resistance in healthcare settings;
provide new insight into cleaning, disinfection and decontamination;
provide new insight into the design of healthcare premises;
describe novel aspects of outbreaks of infection;
throw light on techniques for effective antimicrobial stewardship;
describe novel techniques (laboratory-based or point of care) for the detection of infection or antimicrobial resistance in the healthcare setting, particularly if these can be used to facilitate infection prevention and control;
improve understanding of the motivations of safe healthcare behaviour, or describe techniques for achieving behavioural and cultural change;
improve understanding of the use of IT systems in infection surveillance and prevention and control.
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