Clostridium difficile infection in hospitalized patients with inflammatory bowel disease
نویسندگان
چکیده
To evaluate the frequency, possible risk factors, and outcome of Clostridium difficile infection (CDI) in inflammatory bowel disease (IBD) patients.There has been an upsurge of CDI in patients with IBD who has been associated with increased morbidity and mortality. Various risk factors have been found to predispose IBD patients to CDI.A retrospective case-control study on IBD patients admitted with exacerbation and tested for CDI at the Tel Aviv Medical Center in 2008 to 2013. Epidemiologic, laboratory, and prognostic data were retrieved from electronic files and compared between patients who tested positive (CDI+) or negative (CDI-) for CDI.CDI was identified in 28 of 311 (7.31%) IBD patients hospitalized with diarrhea. IBD-specific risk factors (univariate analysis) for CDI included: use of systemic steroids therapy (odds ratio [OR] = 3.6, 95% confidence interval [CI] 1.2-10.6) and combinations of ≥2 immunomodulator medications (OR = 2.6, 95% CI 1.1-6.3). Additional risk factors for CDI that are common in the general population were hospitalization in the preceding 2 months (OR = 6.0, 95% CI 2.6-14.1), use of antacids (OR = 3.8, 95% CI 1.7-8.4), and high Charlson comorbidity score (OR = 2.5, 95% CI 1.1-5.7). A multivariate analysis confirmed that only hospitalization within the preceding 2 months and use of antacids were significant risk factors for CDI. The prognosis of CDI+ patients was similar to that of CDI- patients.Hospitalized IBD patients with exacerbation treated with antacids or recently hospitalized are at increased risk for CDI and should be tested and empirically treated until confirmation or exclusion of the infection.
منابع مشابه
Clostridium difficile infection in hospitalized patients with inflammatory bowel disease: Prevalence, risk factors, and prognosis: Erratum
متن کامل
Clostridium Difficile Infection Worsen Outcome of Hospitalized Patients with Inflammatory Bowel Disease
The prevalence of Clostridium difficile infection (CDI) in patients suffering from inflammatory bowel disease (IBD) has increased rapidly over the past several decades in North America and Europe. However, the exact global epidemiology remains unclear because of insufficient data from developing countries. A total of 646 hospitalized adult IBD patients were enrolled; and their fresh stool speci...
متن کاملIncidence and risk factors of Clostridium difficile infection in patients with inflammatory bowel disease.
UNLABELLED Recent changes in the epidemiology of Clostridium difficile infection (CDI) include the identification of patients with inflammatory bowel disease (IBD) as a group at risk in comparison to the general population. AIM To identify the incidence and risk factors for CDI among patients with IBD. MATERIAL AND METHODS Case-control study of 78 patients diagnosed with IBD, hospitalized a...
متن کاملClostridium difficile in Relapse of Inflammatory Bowel Disease
42 INTRODUCTION Despite the availability of a growing number of therapeutic options for the treatment of inflammatory bowel disease (IBD), patients in remission remain at constant risk of disease relapse. Clinically, it can be difficult to distinguish between diarrheal relapses of IBD and the presence of enteric infection. Several microorganisms can be seen in association with relapse, includin...
متن کاملManagement of Clostridium difficile Infection in Inflammatory Bowel Disease: Expert Review from the Clinical Practice Updates Committee of the AGA Institute.
The purpose of this expert review is to synthesize the existing evidence on the management of Clostridium difficile infection in patients with underlying inflammatory bowel disease. The evidence reviewed in this article is a summation of relevant scientific publications, expert opinion statements, and current practice guidelines. This review is a summary of expert opinion in the field without a...
متن کامل