常见免疫功能异常人群艰难梭菌感染的流行病学特征及危险因素研究进展

Progress in research of epidemiological characteristics and risk factors of Clostridioides difficile infection in immunocompromised population

  • 摘要: 艰难梭菌感染(CDI)是医院感染防控和流行病学研究中的重要公共卫生问题,免疫功能异常人群因其免疫抑制状态、频繁医疗暴露及抗菌药物使用等因素,成为CDI的高危人群。 本研究概述了重症监护病房患者、人类免疫缺陷病毒感染者、结核病患者及实体器官移植受者等4类常见免疫功能异常人群CDI的流行病学特征、危险因素及防控策略等方面研究进展,分析发现上述4类常见免疫功能异常人群CDI发生率普遍高于普通人群,感染危险因素与免疫抑制程度加深、广谱抗菌药物使用、住院时间延长及侵入性操作等多种因素有关,提示需按不同免疫功能异常人群风险差异进行分类监测、强化抗菌药物使用管理、加强医院感染控制,并采取差异化防控策略。 同时,未来还需开展多中心前瞻性研究,结合免疫学与微生物组学指标,构建风险预测模型,以实现CDI的精准防控。

     

    Abstract: Clostridioides difficile infection is a critical public health concern in nosocomial infection control and epidemiology research. Immunocompromised population is at high risk due to immunosuppression, frequent healthcare exposure, and antibiotic use. This paper summarizes the epidemiological characteristics of C. difficile infection, risk factors and prevention strategies in four key groups: ICU patients, HIV-infected individuals, tuberculosis patients, and solid organ transplant recipients. The analysis indicated that the incidence of C. difficile infection was significantly higher in these groups than in general population. The infection was associated with progressed immunosuppression, broad-spectrum antibiotic use, prolonged hospitalization, and invasive procedures, suggesting the need for the stratified risk surveillance in immunocompromised population, strengthened antibiotic use management, improved nosocomial infection control, and differentiated prevention strategies. It is necessary to conduct multi-center prospective studies integrating immunological and microbiome indicators to develop risk prediction models for the precise prevention and control of C. difficile infection.

     

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