| Abstract | Većina rizičnih čimbenika za bolničku infekciju Clostridioides difficile (CDI) veća je u
bolesnika hospitaliziranih u psihijatrijskoj ustanovi nego u bolesnika liječenih u drugim
vrstama ustanova, ali je broj istraživanja na toj populaciji razmjerno malen. Cilj ovog
istraživanja bio je procijeniti učestalost bolničke CDI u bolesnika liječenih u psihijatrijskoj
bolnici. Provedena je retrospektivna studija incidencije od 2017. do 2021. godine u Klinici
za psihijatriju Sveti Ivan u Zagrebu na populaciji bolesnika hospitaliziranih duže od 48 sati
bez simptoma CDI tijekom prva dva dana po prijemu. Prosječna stopa incidencije (SI) za
pet godina iznosila je 0,88 na 10.000 bolesničkih dana hospitalizacije (95%-tni interval
pouzdanosti, IP 0,70; 1,12). Omjer stopa incidencije (OSI) bio je tijekom 2019. – 2021.
statistički značajno veći nego tijekom 2017. – 2018. i nakon prilagodbe za dob i spol
bolesnika (OSI = 1,82; 95% IP 1,06; 3,12; p = 0,027). Incidencija je bila veća u žena nego
u muškaraca (OSI = 1,97; 95% IP 1,14; 3,38) nakon prilagodbe za dob bolesnika.
Incidencija je bila najveća u dobnoj skupini 75 do 84 godina (stopa incidencije = 6,98
(95% IP 5,01; 9,71) u odnosu na mlađe od 64 godine kada su slučajevi CDI otkrivani vrlo
rijetko. Najveći broj bolesnika s CDI bio je liječen na odjelima za demencije, palijativu i
muškom odjelu za produženo liječenje. Čini se da opća populacija hospitaliziranih
psihijatrijskih bolesnika nema rizik za CDI viši od bolesnika u drugim ustanovama, ali radi
se o heterogenoj populaciji u kojoj neke skupine bolesnika na određenim odjelima imaju
izrazito povišene rizike i zahtijevaju posebnu skrb. |
| Abstract (english) | Most risk factors for hospital-acquired Clostridioides difficile infection (CDI) are higher in
patients hospitalized in psychiatric institutions than in patients treated in other types of
institutions, but the number of studies on this population is relatively small. The aim of this
study was to assess the frequency of nosocomial CDI in patients treated in a psychiatric
hospital. A retrospective incidence study was conducted from 2017 to 2021 at the Sveti
Ivan Psychiatry Clinic in Zagreb on the population of patients hospitalized for more than
48 hours without CDI symptoms during the first two days after admission. The average
five-year incidence rate (IR) was 0.88 per 10,000 person-days of hospitalization (95%
confidence interval, CI 0.70, 1.12). The incidence rate ratio (IRR) was during 2019 - 2021
statistically significantly higher than during 2017 – 2018. even after adjusting for patient
age (IRR = 1.82; 95% CI 1.06; 3.12; p = 0.027). Incidence was higher in women then in
men (IRR = 1.97; 95% CI 1.14; 3.38) after adjustment for age. Incidence was highest in the
age group 75 to 84 years (IR = 6.98 (95% CI 5.01; 9.71) compared to those younger than
64 when CDI cases were detected very rarely. The largest number of patients with CDI
were treated in dementia, palliative care and male long-term care units. The general
population of hospitalized psychiatric patients does not appear to have a CDI risk higher
than in other institutions, but it is a heterogeneous population in which some groups in
some departments have extremely high risks and require special care. |
