scholarly journals Characteristics of Clostridioides difficile infection in inflammatory bowel disease

2020 ◽  
Author(s):  
Chenjie Tang ◽  
Chengcheng Liu ◽  
Yaping Han ◽  
Xiaohui Zhang ◽  
Wenying Xia ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Molecular Epidemiology ◽  
Bowel Disease ◽  
Treatment Plan ◽  
Clostridioides Difficile ◽  
Quinolone Antibiotics ◽  
Inflammatory Bowel ◽  
Independent Risk Factors ◽  
And Gender

Abstract Background: The epidemiology of Clostridioides difficile infection(CDI) in China is different from western countries and the characteristics of CDI among inflammatory bowel disease (IBD) in China may be unique. The aim of this study was to investigate the molecular epidemiology and to find out the risk factors of CDI among IBD inpatients in Jiangsu Province, China. Methods: Patients with IBD admitted to the First Affiliated Hospital with Nanjing Medical University from August 2013 to December 2018 were enrolled. IBD patients were matched with non IBD patients according to age and gender. Diarrhea samples were sent for CDI diagnosis and the molecular epidemiology investigation was performed. Finally, patients’ information was collected and logistic regression analysis was performed to analyze the independent risk factors of CDI in IBD patients. Results: In this study, the incidence of CDI in IBD patients was much higher than that in non IBD patients (24.6% vs. 9.0%) and community acquired infection was the main kind. The predominant type of epidemic strain of C. difficile in this study was ST54. The shorter history of IBD and recent use of quinolone antibiotics were independent risk factors for CDI among diarrhea patients with IBD. Conclusion: If the duration of IBD is within one year or quinolone antibiotics have been used recently, clinicians should consider the possibility of IBD patients complicated with CDI and adjust the treatment plan.

scholarly journals Clostridioides difficile Enteritis in Patients Following Total Colectomy—a Rare but Genuine Clinical Entity

2019 ◽  
Vol 6 (11) ◽  
Author(s):  
Robert J Ulrich ◽  
Jonathan Bott ◽  
Hannah Imlay ◽  
Kerri Lopez ◽  
Sandro Cinti ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Total Colectomy ◽  
Severe Disease ◽  
Clinical Entity ◽  
Acid Suppression ◽  
Clostridioides Difficile ◽  
Inflammatory Bowel ◽  
One Year

Clostridioides difficile enteritis (CDE) after colectomy is an understudied infectious syndrome. We reviewed 20 years of post-colectomy data and found CDE in 44/855 (5.1%) patients, usually within one year of surgery. Risk factors include acid suppression, inflammatory bowel disease, and antibiotics with enteral feeds. Clostridioides difficile enteritis often presents with severe disease requiring hospitalization.

scholarly journals Novel risk factors and outcomes in inflammatory bowel disease patients with Clostridioides difficile infection

2021 ◽  
Vol 14 ◽  
pp. 175628482199779
Author(s):  
Elida Voth ◽  
Dipesh Solanky ◽  
Edward V. Loftus ◽  
Darrell S. Pardi ◽  
Sahil Khanna
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Bowel Disease ◽  
Adverse Outcomes ◽  
Clostridioides Difficile ◽  
Increased Risk ◽  
Clostridioides Difficile Infection ◽  
Inflammatory Bowel ◽  
Antidepressant Use ◽  
Statin Use

Background: Patients with inflammatory bowel disease (IBD) are at significantly increased risk for Clostridioides difficile infection (CDI) with an increased risk of adverse outcomes including increased in-hospital mortality, IBD treatment failure, re-hospitalization, and high CDI recurrence rates. The existing literature on predictors of these adverse outcomes is limited. We evaluated four potentially modifiable novel risk factors [body mass index (BMI), statin use, opioid use, and antidepressant use] on CDI risk and adverse outcomes in these patients. Methods: Using a retrospective design, variables were abstracted from records for patients with IBD and CDI from 2008 to 2013. Statistical analysis comprised descriptive statistics and univariate and multivariate logistic regression analyses. Results: There were 137 patients with IBD and CDI included in this study. On multivariate analysis controlling for age, 43% of patients in the overweight BMI category had severe or severe, complicated CDI, compared with 22% of patients in the underweight/normal BMI [odds ratio (OR) 2.85, p = 0.02] and 19% in the obese category (OR 3.95, p = 0.04). Statin use was associated with severe or severe, complicated CDI when controlling for age and BMI (OR 5.66, p = 0.01). There was no association between statin use and IBD exacerbations following CDI. Opioid and antidepressant use were not associated with disease severity or frequency of IBD exacerbations following CDI. Conclusions: An overweight BMI and statin use were associated with severe or severe, complicated CDI in IBD patients. Further studies are needed to better understand how these factors impact management of patients with IBD to improve clinical outcomes and potentially reduce the risk of complications from CDI.

scholarly journals Molecular epidemiology of Clostridioides difficile in patients with inflammatory bowel disease in China

2019 ◽  
Author(s):  
Tao Lv ◽  
Yunbo Chen ◽  
Lisi Zheng ◽  
Tao Wu ◽  
Ping Shen ◽  
...  
Keyword(s):  
Inflammatory Bowel Disease ◽  
Molecular Epidemiology ◽  
Bowel Disease ◽  
Pediatric Patients ◽  
Resistance Rate ◽  
Toxin B ◽  
Clostridioides Difficile ◽  
Inflammatory Bowel ◽  
Toxigenic Strains ◽  
Pediatric Ibd

Abstract Background: Clostridioides difficile (C. difficle) infection (CDI) in inflammatory bowel disease (IBD) patients can be recurrent, resulting in poor outcomes, but the molecular characterization of C. difficle in IBD patients remains to be well-established in China. This study aimed to investigate the molecular epidemiology of C. difficile in adult and pediatric IBD patients in China. Methods: C. difficile strains were isolated and identified from the fecal samples of adult and pediatric IBD patients. Toxigenic strains were typed using multilocus sequence typing (MLST), and susceptibility to 10 antimicrobials was evaluated using E-test.Results: Among the 838 IBD patients, 96 (11.5%) patients were positive for CDI, which comprised of 53 adult (9.6%) and 43 children (14.9%) cases. Isolates positive for both toxin A and toxin B genes (A+B+) accounted for 90.2% (74/82), while the remaining 9.8% were negative for toxin A, but positive for toxin B (A–B+). These toxigenic strains were susceptible to metronidazole and vancomycin, but highly resistant to clindamycin, levofloxacin, erythromycin and ciprofloxacin. Furthermore, the isolates obtained from pediatric patients had a significantly higher resistance rate to clindamycin, when compared to isolates obtained from adult CDI (p=0.009). In addition, these toxigenic strains were categorized as 18 sequence types (STs). The dominant types consisted of ST-35 (20.7%), ST-2 (17.1%), ST-54 (13.4%) and ST-3 (13.4%) in all patients, ST-2 (19.6%), ST-35 (15.2%) and ST-54 (13.0%) in adult patients, and ST-35 (27.8%), ST-3 (19.4%), ST-2 (13.9%), ST-54 (13.9%) and ST-37(8.3%) in pediatric patients, respectively. All isolates formed three distinct clusters in the phylogenetic analysis. Conclusions: The incidence and molecular epidemiology of C. difficile infection in adult IBD patients resembled CDI in the general inpatient population. A higher antibiotic resistance rate was identified among the C. difficile isolates obtained from pediatric IBD patients, and few STs accounted for most multidrug-resistant strains. However, the molecular genetic features of the same ST-type between these two groups remained highly correlated.

scholarly journals A nationwide survey concerning the mortality and risk of progressing severity due to arterial and venous thromboembolism in inflammatory bowel disease in Japan

2021 ◽  
Author(s):  
Katsuyoshi Ando ◽  
Mikihiro Fujiya ◽  
Kenji Watanabe ◽  
Sakiko Hiraoka ◽  
Hisashi Shiga ◽  
...  
Keyword(s):  
Risk Factors ◽  
Inflammatory Bowel Disease ◽  
Risk Factor ◽  
Venous Thromboembolism ◽  
Bowel Disease ◽  
Severe Disease ◽  
Laboratory Data ◽  
Nationwide Survey ◽  
Inflammatory Bowel ◽  
Independent Risk Factors

Abstract Background The mortality and risk factors of severe disease and death due to arterial and venous thromboembolism (ATE and VTE, respectively) in patients with inflammatory bowel disease (IBD) remain unclear, especially in Asia. Aims This study aimed to reveal the mortality and risk factors of TE in IBD patients in Japan. Methods In the primary surveillance, responses to questionnaires regarding the number of cases of severe TE and TE-associated death in IBD patients in a span of over the past 10 years were obtained from 32 institutions in Japan. In the secondary surveillance, detailed data about IBD patients with TE were collected. The characteristics, laboratory data, therapy status, and situation at the time of TE development were retrospectively collected, and the data were compared between the patients with and without severe TE and TE-associated death. Results The incidence of TE was 1.89% among 31,940 IBD patients. The frequencies of severe TE and TE-associated mortality were 10.7% and 1.0% among the total IBD and TE with IBD patients, respectively. The only risk factor for severe ATE and ATE-associated death was ischemic heart disease. The independent risk factors for severe VTE and VTE-associated death were age (≤ 45 years old), the site of VTE, and disease severity, with anti-TNF therapy as a potential negative risk factor. Patients with severe VTE had a high risk of developing persistent VTE and sequelae. Conclusion Unlike ATE, the incidence of VTE was comparable in Asian and Western countries. Therapeutic and prophylactic strategies for managing IBD-associated TE in Asia are urgently needed.

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