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Title: Konsumpcja antybiotyków oraz zachorowalność związana z zakażeniami Clostridioides difficile w wybranych populacjach pacjentów w Polsce
Abstract:
Clostridioides difficile is a common bacteria in humans, but pathogenic strains may contribute to the development of so-called antibiotic diarrhea in which the main factor of exposure to infection is taking antibiotics. In healthy people, the main protection against CDI (C. difficile infection) is the normal mucosa along with the microbiota that can be disrupted by antibiotics. Other significant risk factors for CDI occurrence are age, hospitalization, and previous operations. In 2016, the average incidence of CDI in the EU was 2.38 / 10,000 patient-days (pds), and in Poland as much as 6.2 / 10,000 pds. As CDI infections are closely related to antibiotic therapy, it is suggested that CDI may be considered as biomarker of the appropriate antibiotic use. The aim of the study was to evaluate the local, national and European epidemiology of C. difficile in the context of the use of antibiotics in prophylaxis and treatment. Surveillance of CDI covered surgical patients of treatment wards at the St. Łukasz in Tarnów. In addition, data was obtained from the Polish National Health Fund (NHF) and ECDC databases on the presence of CDI and the prescription or use of antibiotics. Data concerning: consumption |of antibiotics, incidence of CDI, length of hospitalization, and patient characteristics were analyzed. In the Healthcare-Associated CDI (HA-CDI) local study, the incidence of infect ; ions was 2/1000 patients. The highest use of antibiotics was recorded in the urology department, where a high proportion of fluoroquinolones was observed. It has also been shown that the use of fluoroquinolones was strongly positively associated with the occurrence of CDI. The incidence rate of national study HA-CDI was 34.4/ 10,000 patients. It has been reported that patients who required polytherapy in the preoperative period, who were admitted urgently, operated for trauma, who required hospitalization at the ICU or who required long-term care after discharge, significantly have CDI often. It has been shown that CDI was significantly more frequent in patients with other infections and in patients who were prescribed an antibiotic in the postoperative period. The European analysis showed that in Poland the share of outpatient antibiotics consumption was 16.3 times higher than in the hospital environment, which was one of the highest results among European countries. There also was a high incidence of CDI in Poland (7.6 / 10,000 pds), while the average incidence in Europe was 4.6 cases / 10,000 pds. At the European level, no significant relationship was found between the consumption of antibiotics and the incidence of CDI. It is a confirmation that looking for solutions to problems as universal as CDI prevention and control necessitates detailed descriptions of the local situa ; tion and local conditions and limitations. The presented results have several important implications for clinical practice in Poland, especially in infection prevention and control. Preoperative multimorbidity and antibiotic consumption are associated with an increased risk of CDI. Thus, the observation confirms the need to implement effective infection prevention and control programs as well as the simultaneous antibiotics stewardship in Polish hospitals.
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Rada Dyscypliny Nauki medyczne
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Last modified:
Jul 1, 2024
In our library since:
Jun 5, 2024
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http://dl.cm-uj.krakow.pl:8080/publication/5132
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| Edition name | Date |
|---|---|
| ZB-140240 | Jul 1, 2024 |
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