艰难梭菌感染在妇产科患者中的作用

B. Ștefănescu, G. Constantin
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摘要

在发展中国家,医院感染,或者换句话说,医疗保健相关感染的发生率更高。世界卫生组织(WHO)估计,多达15%的住院患者将感染与医疗程序有关的感染。医院病原体包括病毒、细菌、真菌和寄生虫。污染的途径是不同的,这些途径可以由环境来源、卫生保健人员或其他受感染的患者来代表。在过去的几十年里,艰难梭菌感染在住院患者中变得越来越频繁。不幸的是,并非所有病例都得到了报告,有些患者在出院后在其他医疗机构得到了诊断。妇科手术以及产科患者已经有许多感染的危险因素。在这些患者中增加艰难梭菌感染可能是灾难性的。因此,报告的艰难梭菌感染在妇科和产科患者中的发病率上升应该是令人震惊和不可接受的,因为病原体是通过未适当清洁的医务人员的手从一个受感染的患者传播到另一个。虽然艰难梭菌感染的主要危险因素是使用广谱抗生素,但治疗也是抗生素。因此,不建议妇科手术患者过度使用预防性抗生素治疗。
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Clostridium difficile infection in obstetrics and gynecology patients
The incidence of nosocomial infections or, in other words, healthcare-associated infections, is bigger in developing countries. World Health Organisation (WHO) estimates that as much as 15% of all hospitalized patients will contract an infection related to medical procedures. Nosocomial pathogens are represented by viruses, bacteria, fungal and parasites. The pathway of contamination is different and these could be represented by environmental sources, healthcare staff or other infected patients. Over the past decades, Clostridium difficile infection became more and more frequent in hospitalized patients. Unfortunately, not all the cases are reported and some of the patients are diagnosed with time after discharge, in other medical services. Gynecologic surgery, as well as obstetric patients already, have numerous risk factors for infection. The addition of Clostridium difficile infection in these patients could be catastrophal. Thus, the reported rising incidence of Clostridium difficile infection in gynecological and obstetric patients should be alarming and unacceptable since the pathogen is transmitted from one infected patient to another through unproperly cleaned medical staff hands. Although the main risk factor for Clostridium difficile infection is the use of broad-spectrum antibiotics, the treatment is also antibiotic. Thus, the overuse of prophylactic antibiotherapy in patients undergoing gynecologic surgery should not be recommended.s.
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