BACKGROUND Patients with schizophrenia, bipolar disorder, and major depressive disorder (MDD) have increased infections. We explored the association between recent antimicrobial exposure and acute psychiatric illness. METHODS We performed a retrospective chart review of 267 acutely ill patients age 18 to 65. There were 92 patients with schizophrenia, 42 with bipolar disorder, 61 with MDD, and 72 with alcohol use disorders (hospitalized controls). Recent antimicrobial exposure was defined as occurring within 3 days of psychiatric hospitalization. RESULTS The prevalence of recent antimicrobial exposure was significantly increased in acutely ill patients with schizophrenia (16%), bipolar disorder (21%), and MDD (18%) compared with patients who had alcohol use disorders (4%, P ≤ .01 for each). After controlling for potential confounders, participants with schizophrenia or mood disorders were 5 to 7 times more likely to have recent antimicrobial exposure than participants with alcohol use disorders (schizophrenia: odds ratio [OR] = 4.5, 95% confidence interval [CI] 1.0-21.0, P = .053; bipolar disorder: OR = 6.9, 95% CI 1.3-35.7, P = .022; MDD: OR = 5.7, 95% CI 1.2-28.3, P = .032). Among participants with mood disorders, the association was stronger for participants with depression and affective psychosis compared with participants with alcohol use disorders. CONCLUSIONS We found an increased prevalence of recent antimicrobial exposure in acutely ill patients with schizophrenia and mood disorders. The findings provide additional evidence that infections are relevant to acute psychiatric illness.

中文翻译：

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急性精神病住院患者和抗菌药物暴露

背景 患有精神分裂症、双相情感障碍和重度抑郁症 (MDD) 的患者感染增加。我们探讨了近期抗生素暴露与急性精神疾病之间的关联。方法 我们对 267 名 18 至 65 岁的急性病患者进行了回顾性图表审查。其中 92 名精神分裂症患者、42 名双相情感障碍患者、61 名 MDD 患者和 72 名酒精使用障碍患者（住院对照）。最近的抗生素暴露被定义为发生在精神病院住院 3 天内。结果 与患有酒精使用障碍的患者（4%，P ≤ .01）相比，患有精神分裂症（16%）、双相情感障碍（21%）和 MDD（18%）的急性病患者近期抗生素暴露的患病率显着增加每个）。在控制了潜在的混杂因素后，精神分裂症或情绪障碍参与者近期接触抗生素的可能性是酒精使用障碍参与者的 5 到 7 倍（精神分裂症：优势比 [OR] = 4.5，95% 置信区间 [CI] 1.0-21.0，P = .053 ；双相情感障碍：OR = 6.9，95% CI 1.3-35.7，P = .022；MDD：OR = 5.7，95% CI 1.2-28.3，P = .032）。在情绪障碍参与者中，与酒精使用障碍参与者相比，抑郁和情感性精神病参与者的关联更强。结论 我们发现，在患有精神分裂症和情绪障碍的急性病患者中，近期抗生素暴露的流行率有所增加。这些发现提供了额外的证据，证明感染与急性精神疾病有关。