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- 저자 : Alfredo Ponce-de-León (검색결과 1 건)
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Yu Ling Lee-Tsai,Rodrigo Luna-Santiago,Roberta Demichelis-Gómez,Alfredo Ponce-de-León,Eric Ochoa-Hein,Karla María Tamez-Torres,María T Bourlon,Christianne Bourlon 대한혈액학회 2019 Blood Research Vol.54 No.2
BackgroundClostridium difficile infection (CDI) is a nosocomial condition prevalent in patients with hematological disorders. We aimed to identify the risk factors associated with the devel-opment of CDI and assess the mortality rate at 15 and 30 days among hematologic patients admitted to a tertiary care center.MethodsWe conducted a retrospective case-control study from January 2010 to December 2015. Forty-two patients with hematologic malignancy and CDI, and 84 with hematologic dis-ease and without history of CDI were included in the case and control groups, respectively.ResultsUnivariate analysis revealed that episodes of febrile neutropenia [odds ratio (OR), 5.5; 95% confidence interval (CI), 2.3‒12.9; P<0.001], admission to intensive care unit (OR, 3.8; 95% CI, 1.4‒10.2; P=0.009), gastrointestinal surgery (OR, 1.2; 95% CI, 1.1‒1.4; P<0.001), use of therapeutic (OR, 6.4; 95% CI, 2.5‒15.9; P<0.001) and prophylactic antibiotics (OR, 4.2; 95% CI, 1.6‒10.7; P=0.003) in the last 3 months, and >1 hospital-ization (OR, 5.6; 95% CI, 2.5‒12.6; P<0.001) were significant risk factors. Multivariate analysis showed that use of therapeutic antibiotics in the last 3 months (OR, 6.3; 95% CI, 2.1‒18.8; P=0.001) and >1 hospitalization (OR, 4.3; 95% CI, 1.7‒11.0; P=0.002) were independent risk factors. Three (7.1%) and 6 (14.2%) case patients died at 15 and 30 days, respectively.ConclusionThe risk factors for developing CDI were exposure to therapeutic antibiotics and previous hospitalization. Hematological patients who developed CDI had higher early mortality rates, suggesting that new approaches for prevention and treatment are needed.
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