ABSTRACT
Clostridium difficile is the most common cause of hospital-acquired diarrhea in patients treated with antibiotics, chemotherapeutic agents, and other drugs that alter the normal equilibrium of the intestinal flora. A better understanding of the risk factors for C. difficile-associated disease (CDAD) could be used to reduce the incidence of CDAD and the costs associated with its treatment. The aim of this study was to identify the risk factors for CDAD in a cohort of Chinese patients in a Beijing hospital. Medical charts of a total of 130 inpatients (62 males and 68 females) with hospital-acquired diarrhea (45 with CDAD; 85 without CDAD) were retrospectively reviewed. C. difficile toxins A and B were detected in fecal samples using enzyme-linked fluorescence assays. The drugs used by patients with and without CDAD before the onset of diarrhea were compared. Factors that differed significantly between the two groups by univariate analysis were analyzed by multivariate analysis using a logistic regression model. Multivariate analysis showed that cephalosporin treatment was associated with a significantly higher risk of CDAD in hospitalized patients, while treatment with glycopeptides was significantly associated with a reduction in CDAD (P<0.001 for cephalosporin; P=0.013 for glycopeptides). Our data confirmed previous findings that empirical treatment with cephalosporins is positively associated with CDAD compared to individuals using other CDAD-related drugs. Additionally, we showed that treatment with glycopeptides was negatively associated with CDAD, compared to individuals using other CDAD-related drugs.
Subject(s)
Adult , Aged , Aged, 80 and over , Female , Humans , Male , Middle Aged , Anti-Bacterial Agents/adverse effects , Clostridioides difficile/pathogenicity , Cross Infection/microbiology , Diarrhea/microbiology , Enterocolitis, Pseudomembranous/microbiology , Bacterial Proteins/isolation & purification , Bacterial Toxins/isolation & purification , Cephalosporins/adverse effects , China/epidemiology , Cross Infection/epidemiology , Enterocolitis, Pseudomembranous/epidemiology , Enterotoxins/isolation & purification , Feces/microbiology , Glycopeptides/therapeutic use , Incidence , Logistic Models , Multivariate Analysis , Retrospective Studies , Risk Factors , Statistics, NonparametricABSTRACT
Influenza surveillance networks in Guangdong were established to investigate the epidemiological characteristics of influenza and influenza epidemics. Influenza activity peaked annually from March to July in Guangdong in 1991-2000; influenza H3N2 predominated in the epidemic (7 years of 10); the outbreak of influenza in 1996 was the remarkable result of antigenic drift of H3N2 strain. Ten isolates of H9N2 strains were discovered from human subjects in 1998 and 1999: chicken strains isolated after the Hong Kong fowl influenza outbreak. It was found that there was just one influenza activity season per annum in Guangdong and that the influenza H3N2 subtype still predominates in Guangdong. Further research into the pathogenicity of influenza H9N2 in humans warranted.