プロトンポンプ阻害薬およびカリウムイオン競合型アシッドブロッカーがClostridioides difficile感染発症に及ぼす影響
「緒言」Clostridioides difficile(C. difficile)は医療関連感染による下痢症の主な原因の1つであり, 重症化すると腸閉塞, 消化管穿孔, 敗血症などを引き起こし, 死亡率(関連合併症を含む)は3.4～15.1%と報告されている. 近年C. difficile infection(CDI)の有病率は増加傾向にあり, 特に高齢者で有病率・再発率・死亡率が高く, 超高齢者社会をむかえようとしている本邦では, CDIが更に増加することが予想される. さらに, Gaoらが行ったシステマティックレビュー(12文献, CDI:8,509例, 対照:247,285例)では,...
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| Published in | 医療薬学 Vol. 48; no. 12; pp. 570 - 576 |
|---|---|
| Main Authors | , , , , , , , , |
| Format | Journal Article |
| Language | Japanese |
| Published |
一般社団法人日本医療薬学会
10.12.2022
日本医療薬学会 |
| Subjects | |
| Online Access | Get full text |
| ISSN | 1346-342X 1882-1499 |
| DOI | 10.5649/jjphcs.48.570 |
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| Abstract | 「緒言」Clostridioides difficile(C. difficile)は医療関連感染による下痢症の主な原因の1つであり, 重症化すると腸閉塞, 消化管穿孔, 敗血症などを引き起こし, 死亡率(関連合併症を含む)は3.4～15.1%と報告されている. 近年C. difficile infection(CDI)の有病率は増加傾向にあり, 特に高齢者で有病率・再発率・死亡率が高く, 超高齢者社会をむかえようとしている本邦では, CDIが更に増加することが予想される. さらに, Gaoらが行ったシステマティックレビュー(12文献, CDI:8,509例, 対照:247,285例)では, CDIは院内死亡(CDI関連合併症を含む)のリスク因子(オッズ比:1.90, 95%信頼区間:1.269-2.840)であると報告しており, 医療現場においてC. difficileの制御は医療関連感染対策上, 必須である. CDIのリスク因子として基礎疾患(炎症性腸疾患, 慢性腎臓病), 入院歴, ICU滞在歴, 消化管手術歴などが挙げられているが, 最大の因子は抗菌薬投与である. |
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| AbstractList | 「緒言」Clostridioides difficile(C. difficile)は医療関連感染による下痢症の主な原因の1つであり, 重症化すると腸閉塞, 消化管穿孔, 敗血症などを引き起こし, 死亡率(関連合併症を含む)は3.4～15.1%と報告されている. 近年C. difficile infection(CDI)の有病率は増加傾向にあり, 特に高齢者で有病率・再発率・死亡率が高く, 超高齢者社会をむかえようとしている本邦では, CDIが更に増加することが予想される. さらに, Gaoらが行ったシステマティックレビュー(12文献, CDI:8,509例, 対照:247,285例)では, CDIは院内死亡(CDI関連合併症を含む)のリスク因子(オッズ比:1.90, 95%信頼区間:1.269-2.840)であると報告しており, 医療現場においてC. difficileの制御は医療関連感染対策上, 必須である. CDIのリスク因子として基礎疾患(炎症性腸疾患, 慢性腎臓病), 入院歴, ICU滞在歴, 消化管手術歴などが挙げられているが, 最大の因子は抗菌薬投与である. |
| Author | 髙取, 士剛 久保, 淳一 渡邉, 愛悠 佐藤, 智香 和泉, 秀明 岩堀, 真弓 小原, 郁司 樋浦, 一哉 田畑, 裕和 |
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新規カリウムイオン競合型アシッドブロッカーボノプラザンフマル酸塩（タケキャブ®錠10 mgおよび20 mg）の薬理学的特性および臨床効果, 日本薬理学雑誌, 2015, 146, 275-282. 7）Kanamori LF, Stone JC, Clark J, Mckenzie SJ, Yakob L, Paterson DL, Riley TV, Doi SAR, Clements AC, Comorbidities, Exposure to Medications, and the Risk of Community-Acquired Clostridium difficile Infection: a systematic review and meta-analysis, Infect Cont Hosp Ep, 2015, 36, 132-141. 4）Asempa TE, Nicolau DP, Clostridium difficile infection in the elderly: an update on management, Clin Interv Aging, 2017, 12, 1799-1809. 24）Cunningham R, Dial S, Is over-use of proton pump inhibitors fuelling the current epidemic of Clostridium difficile-associated diarrhea?, J Hosp Infect, 2008, 70, 1-6. 36）Shen NT, Maw A, Tmanova LL, Pino A, Ancy K, Crawford CV, Simon MS, Evans AT, Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis, Gastroenterology, 2017, 152, 1889-1900. 3）Kassam Z, Fabersunne CC, Smith MB, Alm EJ, Kaplan GG, Nguyen GC, Ananthakrishnan AN, Clostridium difficile associated risk of death score (CARDS): a novel severity score to predict mortality among hospitalised patients with Clostridium difficile infection, Aliment Pharmacol Ther, 2016, 43, 725-733. 16）Azab M, Doo L, Doo DH, Elmofti Y, Ahmed M, Cadavona JJ, Liu XB, Shafi A, Joo MK, Yoo JW, Comparison of the Hospital-Acquired Clostridium difficile Infection Risk of Using Proton Pump Inhibitors versus Histamine-2 Receptor Antagonists for Prophylaxis and Treatment of Stress Ulcers: A Systematic Review and Meta-Analysis, Gut Liver, 2017, 11, 781-788. 20）Sjölander A, Propensity scores and M-structures, Stat Med, 2009, 28, 1416-1420. 28）Warrington S, Baisley K, Boyce M, Tejura B, Morocutti A, Miller N, Effect of rabeprazole, 20 mg, or esomeprazole, 20 mg, on 24-h intragastric pH and serum gastrin in healthy subjects, Aliment Pharmacol Ther, 2002, 16, 1301-1307. 30）Miner PB, Allgood LD, Grender JM, Comparison of gastric pH with omeprazole magnesium 20.6 mg (Prilosec OTC) o.m. famotidine 10 mg (Pepcid AC）b.d. and famotidine 20 mg b.d. over 14 days of treatment, Aliment Pharmacol Ther, 2007, 25, 103-109. 31）Norris V, Baisley K, Dunn K, Warrington S, Morocutti A, Combined analysis of three crossover clinical pharmacology studies of effects of rabeprazole and esomeprazole on 24-h intragastric pH in healthy volunteers, Aliment Pharmacol Ther, 2007, 25, 501-510. 32）Jenkins H, Sakurai Y, Nishimura A, Okamoto H, Hibberd M, Jenkins R, Yoneyama T, Ashida K, Ogama Y, Warrington S, Randomised clinical trial: safety, tolerability, pharmacokinetics and pharmacodynamics of repeated doses of TAK-438 (vonoprazan), a novel potassium-competitive acid blocker, in healthy male subjects, Aliment Pharmacol Ther, 2015, 41, 636-648. 1）Riley TV, Kimura T, The Epidemiology of Clostridium difficile Infection in Japan: A Systematic Review, Infect Dis Ther, 2018, 7, 39-70. 21）青木 眞, “レジデントのための感染症診療マニュアル”, 第4版, 医学書院, 東京, 2020, p794. 23）Austin PC, An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies, Multivariate Behav Res, 2011, 46, 399-424. 22）大林 準, ロジスティック回帰分析と傾向スコア（propensity score）解析, 天理医学紀要, 2016, 19, 71-79. 10）Abdelsattar ZM, Krapohl G, Alrahmani L, Banerjee M, Krell RW, Wong SL, Campbell DA, Aronoff DM, Hendren S, Postoperative burden of hospital-acquired Clostridium difficile infection, Infect Cont Hosp Ep, 2015, 36, 40-46. 34）Permpalung N, Upala S, Sanguankeo A, Sornprom S, Association between NSAIDs and Clostridium difficile-Associated Diarrhea: A Systematic Review and Meta-Analysis, Can J Gastroenterol Hepatol, 2016, 2016, 7431838. doi: 10.1155/2016/7431838. 5）Gao T, He B, Pan Y, Deng Q, Sun H, Liu X, Chen J, Wang S, Xia Y, Association of Clostridium difficile infection in hospital mortality: A systematic review and meta-analysis, Am J Infect Control, 2015, 43, 1316-1320. 13）Vardakas KZ, Trigkidis KK, Boukouvala E, Falagas ME, Clostridium difficile infection following systemic antibiotic administration in randomised controlled trials: a systematic review and meta-analysis, Int J Antimicrob Agents, 2016, 48, 1-10. 19）Otsuka T, Sugimoto M, Inoue R, Ohno M, Ban H, Nishida A, Inatomi O, Takahashi S, Naito Y, Andoh A, Influence of potassium-competitive acid blocker on the gut microbiome of Helicobacter pylori-negative healthy individuals, Gut, 2017, 66, 1723-1725. 25）Trifan A, Stanciu C, Girleanu I, Stoica OC, Singeap AM, Maxim R, Chiriac SA, Ciobica A, Boiculese L, Proton pump inhibitors therapy and risk of Clostridium difficile infection: Systematic review and meta-analysis, World J Gastroenterol, 2017, 23, 6500-6515. 26）Haley RW, Schaberg DR, Crossley KB, Von Allmen SD, McGowan JE, Extra charges and prolongation of stay attributable to nosocomial infections: A prospective interhospital comparison, Am J Med, 1981, 70, 51-58. 33）Rubin DB, Estimating causal effects from large data sets using propensity scores, Ann Intern Med, 1997, 127, 757-763. 12）Thomas C, Stevenson M, Riley TV, Antibiotics and hospital-acquired Clostridium difficile-associated diarrhoea: a systematic review, J Antimicrob Chemother, 2003, 51, 1339-1350. 35）Wijarnpreecha K, Sornprom S, Thongprayoon C, Phatharacharukul P, Cheungpasitporn W, Nakkala K, The risk of Clostridium difficile associated diarrhea in nasogastric tube insertion: A systematic review and meta-analysis, Dig Liver Dis, 2016, 48, 468-472. 29）Yang E, Kim S, Kim B, Kim B, Kim Y, Park SS, Song GS, Yu KS, Jang IJ, Lee SH, Night-time gastric acid suppression by tegoprazan compared to vonoprazan or esomeprazole, Br J Clin Pharmacol, 2022, 88, 3288-3296. 6）Singh H, Nugent Z, Yu BN, Lix LM, Targownik LE, Bernstein CN, Higher Incidence of Clostridium difficile Infection Among Individuals With Inflammatory Bowel Disease, Gastroenterology, 2017, 153, 430-438. 2）CDI診療ガイドライン作成委員編, “Clostridioides （Clostridium） difficile感染症診療ガイドライン”, 杏林舎, 東京, 2018, pp7-29. 14）Cao F, Chen CX, Wang M, Liao HR, Wang MX, Hua SZ, Huang B, Xiong Y, Zhang JY, Xu YL, Updated meta-analysis of controlled observational studies: proton-pump inhibitors and risk of Clostridium difficile infection, J Hosp Infect, 2018, 98, 4-13. 15）Leonard J, Marshall JK, Moayyedi P, Systematic review of the risk of enteric infection in patients taking acid suppression, Am J Gastroenterol, 2007, 102, 2047-2056. 27）Thomson A, Kirdeikes P, Jamali F, Tavernini M, Zuk L, Marriage B, Simpson I, Mahachai V, Effect of nizatidine and ranitidine on 24 hour intragastric pH, pepsin, prostaglandin E2, and serum gastrin concentrations in healthy volunteers, Gastroenterol Hepatol (NY), 1995, 10, 546-554. 37）Leekha S, Aronhalt KC, Sloan LM, Patel R, Orenstein R, Asymptomatic Clostridium difficile colonization in a tertiary care hospital: Admission prevalence and risk factors, Am J Infect Control, 2013, 41, 390-393. |
| References_xml | – reference: 24）Cunningham R, Dial S, Is over-use of proton pump inhibitors fuelling the current epidemic of Clostridium difficile-associated diarrhea?, J Hosp Infect, 2008, 70, 1-6. – reference: 34）Permpalung N, Upala S, Sanguankeo A, Sornprom S, Association between NSAIDs and Clostridium difficile-Associated Diarrhea: A Systematic Review and Meta-Analysis, Can J Gastroenterol Hepatol, 2016, 2016, 7431838. doi: 10.1155/2016/7431838. – reference: 15）Leonard J, Marshall JK, Moayyedi P, Systematic review of the risk of enteric infection in patients taking acid suppression, Am J Gastroenterol, 2007, 102, 2047-2056. – reference: 30）Miner PB, Allgood LD, Grender JM, Comparison of gastric pH with omeprazole magnesium 20.6 mg (Prilosec OTC) o.m. famotidine 10 mg (Pepcid AC）b.d. and famotidine 20 mg b.d. over 14 days of treatment, Aliment Pharmacol Ther, 2007, 25, 103-109. – reference: 28）Warrington S, Baisley K, Boyce M, Tejura B, Morocutti A, Miller N, Effect of rabeprazole, 20 mg, or esomeprazole, 20 mg, on 24-h intragastric pH and serum gastrin in healthy subjects, Aliment Pharmacol Ther, 2002, 16, 1301-1307. – reference: 13）Vardakas KZ, Trigkidis KK, Boukouvala E, Falagas ME, Clostridium difficile infection following systemic antibiotic administration in randomised controlled trials: a systematic review and meta-analysis, Int J Antimicrob Agents, 2016, 48, 1-10. – reference: 36）Shen NT, Maw A, Tmanova LL, Pino A, Ancy K, Crawford CV, Simon MS, Evans AT, Timely Use of Probiotics in Hospitalized Adults Prevents Clostridium difficile Infection: A Systematic Review With Meta-Regression Analysis, Gastroenterology, 2017, 152, 1889-1900. – reference: 37）Leekha S, Aronhalt KC, Sloan LM, Patel R, Orenstein R, Asymptomatic Clostridium difficile colonization in a tertiary care hospital: Admission prevalence and risk factors, Am J Infect Control, 2013, 41, 390-393. – reference: 17）Howell MD, Novack V, Grgurich P, Soulliard D, Novack L, Pencina M, Talmor D, Iatrogenic Gastric Acid Suppression and the Risk of Nosocomial Clostridium difficile Infection, Arch Intern Med, 2010, 170, 784-790. – reference: 16）Azab M, Doo L, Doo DH, Elmofti Y, Ahmed M, Cadavona JJ, Liu XB, Shafi A, Joo MK, Yoo JW, Comparison of the Hospital-Acquired Clostridium difficile Infection Risk of Using Proton Pump Inhibitors versus Histamine-2 Receptor Antagonists for Prophylaxis and Treatment of Stress Ulcers: A Systematic Review and Meta-Analysis, Gut Liver, 2017, 11, 781-788. – reference: 18）松川 純, 稲富信博, 大竹一嘉, 新規カリウムイオン競合型アシッドブロッカーボノプラザンフマル酸塩（タケキャブ®錠10 mgおよび20 mg）の薬理学的特性および臨床効果, 日本薬理学雑誌, 2015, 146, 275-282. – reference: 11）Yasunaga H, Horiguchi H, Hashimoto H, Matsuda S, Fushimi K, The burden of Clostridium difficile-associated disease following digestive tract surgery in Japan, J Hosp Infect, 2012, 82, 175-180. – reference: 31）Norris V, Baisley K, Dunn K, Warrington S, Morocutti A, Combined analysis of three crossover clinical pharmacology studies of effects of rabeprazole and esomeprazole on 24-h intragastric pH in healthy volunteers, Aliment Pharmacol Ther, 2007, 25, 501-510. – reference: 8）Zacharioudakis IM, Zervou FN, Pliakos EE, Ziakas PD, Mylonakis E, Colonization with toxinogenic C. difficile upon hospital admission, and risk of infection: a systematic review and meta-analysis, Am J Gastroenterol, 2015, 110, 381-390. – reference: 5）Gao T, He B, Pan Y, Deng Q, Sun H, Liu X, Chen J, Wang S, Xia Y, Association of Clostridium difficile infection in hospital mortality: A systematic review and meta-analysis, Am J Infect Control, 2015, 43, 1316-1320. – reference: 22）大林 準, ロジスティック回帰分析と傾向スコア（propensity score）解析, 天理医学紀要, 2016, 19, 71-79. – reference: 9）Karanika S, Paudel S, Zervou FN, Grigoras C, Zacharioudakis IM, Mylonakis E, Prevalence and Clinical Outcomes of Clostridium difficile Infection in the Intensive Care Unit: A Systematic Review and Meta-Analysis, Open Forum Infect Dis, 2015, 3, 186. doi: 10.1093/ofid/ofv186. – reference: 23）Austin PC, An Introduction to Propensity Score Methods for Reducing the Effects of Confounding in Observational Studies, Multivariate Behav Res, 2011, 46, 399-424. – reference: 10）Abdelsattar ZM, Krapohl G, Alrahmani L, Banerjee M, Krell RW, Wong SL, Campbell DA, Aronoff DM, Hendren S, Postoperative burden of hospital-acquired Clostridium difficile infection, Infect Cont Hosp Ep, 2015, 36, 40-46. – reference: 27）Thomson A, Kirdeikes P, Jamali F, Tavernini M, Zuk L, Marriage B, Simpson I, Mahachai V, Effect of nizatidine and ranitidine on 24 hour intragastric pH, pepsin, prostaglandin E2, and serum gastrin concentrations in healthy volunteers, Gastroenterol Hepatol (NY), 1995, 10, 546-554. – reference: 19）Otsuka T, Sugimoto M, Inoue R, Ohno M, Ban H, Nishida A, Inatomi O, Takahashi S, Naito Y, Andoh A, Influence of potassium-competitive acid blocker on the gut microbiome of Helicobacter pylori-negative healthy individuals, Gut, 2017, 66, 1723-1725. – reference: 21）青木 眞, “レジデントのための感染症診療マニュアル”, 第4版, 医学書院, 東京, 2020, p794. – reference: 33）Rubin DB, Estimating causal effects from large data sets using propensity scores, Ann Intern Med, 1997, 127, 757-763. – reference: 2）CDI診療ガイドライン作成委員編, “Clostridioides （Clostridium） difficile感染症診療ガイドライン”, 杏林舎, 東京, 2018, pp7-29. – reference: 3）Kassam Z, Fabersunne CC, Smith MB, Alm EJ, Kaplan GG, Nguyen GC, Ananthakrishnan AN, Clostridium difficile associated risk of death score (CARDS): a novel severity score to predict mortality among hospitalised patients with Clostridium difficile infection, Aliment Pharmacol Ther, 2016, 43, 725-733. – reference: 20）Sjölander A, Propensity scores and M-structures, Stat Med, 2009, 28, 1416-1420. – reference: 1）Riley TV, Kimura T, The Epidemiology of Clostridium difficile Infection in Japan: A Systematic Review, Infect Dis Ther, 2018, 7, 39-70. – reference: 35）Wijarnpreecha K, Sornprom S, Thongprayoon C, Phatharacharukul P, Cheungpasitporn W, Nakkala K, The risk of Clostridium difficile 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| Snippet | 「緒言」Clostridioides difficile(C. difficile)は医療関連感染による下痢症の主な原因の1つであり, 重症化すると腸閉塞, 消化管穿孔, 敗血症などを引き起こし, 死亡率(関連合併症を含む)は3.4～15.1%と報告されている. 近年C. difficile... |
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| SubjectTerms | Clostridioides difficile potassium-competitive acid blocker propensity score matching proton pump inhibitors risk factors |
| Title | プロトンポンプ阻害薬およびカリウムイオン競合型アシッドブロッカーがClostridioides difficile感染発症に及ぼす影響 |
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