Clostridium difficile Infection and Inflammatory Bowel Disease

Reddy, Sheela S.; Brandt, Lawrence J.

doi:10.1097/mcg.0b013e31828b288a

Cited by 39 publications

(24 citation statements)

References 64 publications

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“…The recurrence rate may be as high as 25% within 30 days after metronidazole or vancomycin treatment [84,85]. The symptomatic presentations of CDI and IBD are hardly distinguishable (diarrhea, leukocytosis, hypoalbuminemia, and fever) [86,87], and so poses difficulty for pinpoint therapy. Evidence is accumulating on the linking of CDI with IBD flares and relapses, as indicated by 5% to 60% toxin positive rates in the latter [86].…”

Section: Pathogenic Bacteria Associated With Ibdmentioning

confidence: 99%

“…The symptomatic presentations of CDI and IBD are hardly distinguishable (diarrhea, leukocytosis, hypoalbuminemia, and fever) [86,87], and so poses difficulty for pinpoint therapy. Evidence is accumulating on the linking of CDI with IBD flares and relapses, as indicated by 5% to 60% toxin positive rates in the latter [86]. Incidence of CDI is 2.9-, 4.0-, and 2.1-fold of non-IBD controls for IBD, UC and CD patients respectively [88].…”

Section: Pathogenic Bacteria Associated With Ibdmentioning

confidence: 99%

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Manipulation of Microbiome, a Promising Therapy for Inflammatory Bowel Diseases

Jin¹,

Zhang²,

Sun³

2014

J Clin Cell Immunol

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Inflammatory bowel diseases (IBD), including Crohn's disease and ulcerative colitis, are featured by chronic intestinal inflammation, which is becoming increasingly prevalent in Western societies, and is spreading to the rest of the world. Although the etiology of IBD is poorly understood, it is widely accepted that several factors may be crucial, which includes genetics, diet and lifestyle, immunity, environment, and microbiota. In the past decade, huge advances have been made toward a better understanding of IBD, epitomized by far-reaching progress in the field of microbiome. In this review, we summarize the current knowledge of how changes in microbiota may affect the pathogenesis of IBD. Commensal bacteria, benign normally, are essentially opportunists that may readily take over, and potentially contributes to dysbiosis, which, in turn, promotes pathogenesis. Several pathogens, mainly Mycobacterium avium paratuberculosis, adherent invasive Escherichia coli, Clostridium difficile, Campylobacter, and Salmonella, have been shown to be associated with IBD, but the causality remains unproven. The microbiome comprises of not only bacteria, but also viruses, bacteriophages, and fungi. However, little is known as per the role of the latter. We highlight recent research on viruses, bacteriophages, and fungi in IBD. We also discuss the progress on manipulating the microflora to serve therapeutic purposes. The methodology for manipulating the microbiota covers fecal transplantation, pre-, pro-, syn-and post-biotics, helminth therapy, bacteriocins, bacteriophage, etc., which greatly enriches the arsenal against IBD. Manipulation of intestinal microbiome represents a promising type of therapy for IBD.

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Section: Pathogenic Bacteria Associated With Ibdmentioning

confidence: 99%

Section: Pathogenic Bacteria Associated With Ibdmentioning

confidence: 99%

Manipulation of Microbiome, a Promising Therapy for Inflammatory Bowel Diseases

Jin¹,

Zhang²,

Sun³

2014

J Clin Cell Immunol

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“…Due to the high prevalence of CDI in IBD patients and clinical/laboratory similarity between CDI and IBD exacerbation, it is recommended that all IBD patients with a disease flare should be tested for C. difficile (14)(15)(16)(18)(19)(20)(21). There is no indication for post-treatment testing to confirm cure.…”

Section: Diagnosismentioning

confidence: 99%

“…CDI was first associated with IBD in the early 1980s (13), but was somehow neglected until ten years ago, when several studies and reviews clearly demonstrated that patients with one of the two major forms of IBD (ulcerative colitis-UC; Crohn's disease-CD) are at high-risk for CDI (8)(9)(10)(11)(12)(14)(15)(16)(17)(18)(19)(20)(21). Besides the well-known risk factors for CDI in non-IBD population, there are some typical IBD-related risk fac-EPIDEMIOLOGY Both single-center studies (8,9,22,27,(29)(30)(31) and large nationwide data analyses (9,11,12,26) have independently reported an increased CDI incidence among IBD patients.…”

Section: Introductionmentioning

confidence: 99%

Clostridium difficile infection and inflammatory bowel disease

Cojocariu

Stanciu

Stoica³

et al. 2020

Turk J Gastroenterol

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Over the past 15 years, Clostridium difficile infection (CDI) in patients with inflammatory bowel disease (IBD) has increased both in incidence and severity. Traditional risk factors for CDI are similar in IBD and non-IBD populations, but there is a significant proportion of IBD patients which have distinctive characteristics. Patients with ulcerative colitis (UC) are more susceptible to CDI and have more severe outcomes than those with Crohn's disease (CD). CDI may be difficult to distinguish from an IBD flare due to similar clinical presentation, and therefore screening for CDI is recommended at every flare in such patients. Several studies showed worse clinical outcomes in IBD patients with CDI, including longer hospital stay, higher colectomy and mortality rates than in those without CDI. Vancomycin and metronidazole appear to have similar efficacy in patients with moderate disease, but vancomycin is preferred in severe disease. Measures must be taken to prevent the spread of infection. Clinicians should have a high index of suspicion for CDI when evaluating a patient with IBD flare, as rapid detection and prompt treatment of infection improve outcomes. This review summarizes the available literature on epidemiology, risk factors, clinical aspects, diagnostic methods, treatment, outcome, and prevention of CDI in IBD patients.

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“…Risk factors for worsening of preexisting IBD after liver transplant includes active bowel inflammation at the time of transplantation [193], short interval between diagnosis of IBD and transplant [193], cigarette smoking [197], Clostridium difficile infection [198] and use of Tacrolimus after transplant [191,193,199,200]. The use of steroid or immunosuppressive agents prior to transplant does not predict post-transplant IBD activity [194,195].…”

Section: Ibd and Liver Transplantationmentioning

confidence: 99%

A review of liver disorders in inflammatory bowel disease (IBD)

Shah¹,

Gupta²,

Borg³

2017

Clin Case Rep Rev

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Disorders of the liver and the biliary tract are frequently the extraintestinal manifestations of inflammatory bowel disease (IBD). The etiology of these hepato-biliary conditions is deemed secondary to their shared pathogenesis, the chronic effects of a long term, ongoing inflammation of the bowels, along with the medications used to manage IBD. For up to 30% of patients with IBD, abnormal liver biochemical tests are present. Other, selected patients with IBD are followed for reactivation of hepatitis B, through guidelines only relatively recently in place. The vast realm of related clinical conditions does not always correspond well with IBD severity, which can range from mild hepatic insult to end-stage liver disease, necessitating liver transplantation. Hence it is critical to follow its presence, clinical course and long term consequences. Moreover, the management of these disorders is necessarily individualized, with some patients requiring frequent monitoring and others a more multi-disciplinary approach. Studies aimed at improving the outcomes of patients with IBD who experience associated liver and biliary tract disorders are now needed to assess early identification, possible screening approaches and more effective systems of referral. This article covers the evidence-based literature on topics detailing the co-existence of liver conditions in inflammatory bowel disease with a focus on its epidemiology, clinical manifestations, diagnosis and management.

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Clostridium difficile Infection and Inflammatory Bowel Disease

Cited by 39 publications

References 64 publications

Manipulation of Microbiome, a Promising Therapy for Inflammatory Bowel Diseases

Manipulation of Microbiome, a Promising Therapy for Inflammatory Bowel Diseases

Clostridium difficile infection and inflammatory bowel disease

A review of liver disorders in inflammatory bowel disease (IBD)

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