内科理论与实践2025，Vol.20Issue(3)：216-223,8.DOI:10.16138/j.1673-6087.2025.03.06
艰难梭菌毒素阳性延长急诊重症患者住院时间并增加费用
Clostridioides difficile toxin positivity prolongs hospital stay and increases costs for critically ill patients in emer-gency patients
虞美玲 1李娇琰 1黎健 1陈影 1赵冰 1毛恩强 1杨之涛1
作者信息
- 1. 上海交通大学医学院附属瑞金医院急诊科,上海 200025
- 折叠
摘要
Abstract
Objective To explore the influence of Clostridioides difficile(C.difficile)positivity on clinical outcomes and identify associated risk factors in intensive care unit(ICU)patients.Methods A retrospective analysis was conducted on 2 036 patients admitted to the emergency ICU of Ruijin Hospital from 2013 to 2022,comparing outcomes between C.difficile-positive(n=225)and C.difficile negative(n=1 811)groups.Multivariate regression analysis was used to identify risk and protective factors.Results Significantly prolonged hospital stays(B=18.734 d,95%CI:14.683-22.785)and higher treatment costs(B=68 854.912,95%CI:46 579.159-91 130.665)in the C.difficile-positive group,with no statistically significant difference in mortality between groups.Multivariate analysis identified carbapenem use(OR=1.58,95%CI:1.16-2.15),bloodstream infection(OR=1.77,95%CI:1.17-2.66),and biliary tract infection(OR=1.79,95%CI:1.03-3.10)as risk factors for C.difficile positivity.Protective factors included metronidazole use(OR=0.58,95%CI:0.40-0.84),cephalosporin use(OR=0.54,95%CI:0.39-0.74),and female sex(OR=0.60,95%CI:0.44-0.83).Conclusions C.difficile positivity in critically ill patients did not affect mortality but prolonged hospitalization and increased costs.Both risk and protect factors for C.difficile are identified.关键词
艰难梭菌/重症监护室/抗菌药物管理/感染预防Key words
Clostridioides difficile/Intensive care unit/Antimicrobial stewardship/Infection prevention分类
医药卫生引用本文复制引用
虞美玲,李娇琰,黎健,陈影,赵冰,毛恩强,杨之涛..艰难梭菌毒素阳性延长急诊重症患者住院时间并增加费用[J].内科理论与实践,2025,20(3):216-223,8.
