Molecular epidemiology and clinical characteristics of <i>Clostridioides difficile</i> infection in patients with inflammatory bowel disease from a teaching hospital

Li, Yan-Ming; Liao, Jing-Zhong; Jian, Zijuan; Li, Hong-Ling; Chen, Xia; Liu, Qingxia; Liu, Pei-Lin; Wang, Zhiqian; Li, Xuan; Yan, Qun; Liu, Wenen

doi:10.1002/jcla.24773

Cited by 3 publications

(1 citation statement)

References 46 publications

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“…C. difficile infections can trigger flares of IBD and worsen the disease course[ 42 , 43 ]. A recent study suggested PPI use as an independent risk factor for C. difficile infection in IBD patients[ 44 ]. Multiple mechanisms may underlie this association.…”

Section: Mechanisms For Potential Effects Of Ppis On Ibdmentioning

confidence: 99%

Effects of proton pump inhibitors on inflammatory bowel disease: An updated review

Liang,

Meng,

Ding

et al. 2024

World J Gastroenterol

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Inflammatory bowel disease (IBD) is believed to be caused by various factors, including abnormalities in disease susceptibility genes, environmental factors, immune factors, and intestinal bacteria. Proton pump inhibitors (PPIs) are the primary drugs used to treat acid-related diseases. They are also commonly prescribed to patients with IBD. Recent studies have suggested a potential association between the use of certain medications, such as PPIs, and the occurrence and progression of IBD. In this review, we summarize the potential impact of PPIs on IBD and analyze the underlying mechanisms. Our findings may provide insights for conducting further investigations into the effects of PPIs on IBD and serve as an important reminder for physicians to exercise caution when prescribing PPIs to patients with IBD.

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Section: Mechanisms For Potential Effects Of Ppis On Ibdmentioning

confidence: 99%

Effects of proton pump inhibitors on inflammatory bowel disease: An updated review

Liang,

Meng,

Ding

et al. 2024

World J Gastroenterol

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Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital

Liao

Jian

et al. 2022

Clinical Laboratory Analysis

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Background Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is of increasing concern. This study aimed to investigate the molecular epidemiology and antimicrobial susceptibilities of toxigenic C. difficile isolated from IBD patients and to evaluate the risk factors for CDI in IBD population. Methods Loose or watery stools from IBD patients were tested for glutamate dehydrogenase, C. difficile toxins A&B and anaerobic culture. Toxigenic C. difficile isolates were characterized by multi‐locus sequence typing, ribotyping and antimicrobial susceptibility testing. Results The prevalence of CDI in IBD patients was 13.6% (43/317). The dominant sequence types (STs) were ST35 (20.9%), ST2 (18.6%) and ST37 (16.3%). The most common ribotypes (RTs) were RT 017 (18.6%), RT 012 (14.0%), and RT 220 (14.0%), whereas RT 027 and RT 078 were not detected in this study. All the isolates were susceptible to vancomycin and metronidazole. The multidrug resistance rate of C. difficile RT 017 was higher (p < 0.01) than that of other RT strains. Recent hospitalization, use of corticosteroids and proton pump inhibitors were related to increased risk of CDI in IBD patients; of these, recent hospitalization and proton pump inhibitors use were independent risk factors. Conclusion Patients with IBD have a relatively high incidence rate of CDI. C. difficile RT 017 is most frequently isolated from IBD patients in this region and warrants more attention to its high resistance rate. Clinicians should pay greater attention to CDI testing in IBD patients with diarrhea to ensure early diagnosis and initiation of effective treatment.

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Diagnosis and Management of Clostridioides difficile in Inflammatory Bowel Disease

Vaughn,

Khoruts,

Fischer

2024

Am J Gastroenterol

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Patients with inflammatory bowel disease (IBD) have an increased risk of Clostridioides difficile infection (CDI), which can lead to worse IBD outcomes. The diagnosis of CDI in patients with IBD is complicated by higher C. difficile colonization rates and shared clinical symptoms of intestinal inflammation. Traditional risk factors for CDI, such as antibiotic exposure, may be lacking in patients with IBD because of underlying intestinal microbiota dysbiosis. Although CDI disproportionately affects people with IBD, patients with IBD are typically excluded from CDI clinical trials creating a knowledge gap in the diagnosis and management of these 2 diseases. This narrative review aims to provide a comprehensive overview of the diagnosis, treatment, and prevention of CDI in patients with IBD. Distinguishing CDI from C. difficile colonization in the setting of an IBD exacerbation is important to avoid treatment delays. When CDI is diagnosed, extended courses of anti–C. difficile antibiotics may lead to better CDI outcomes. Regardless of a diagnosis of CDI, the presence of C. difficile in a patient with IBD should prompt a disease assessment of the underlying IBD. Microbiota-based therapies and bezlotoxumab seem to be effective in preventing CDI recurrence in patients with IBD. Patients with IBD should be considered at high risk of CDI recurrence and evaluated for a preventative strategy when diagnosed with CDI. Ultimately, the comanagement of CDI in a patient with IBD requires a nuanced, patient-specific approach to distinguish CDI from C. difficile colonization, prevent CDI recurrence, and manage the underlying IBD.

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Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital

Cited by 3 publications

References 46 publications

Effects of proton pump inhibitors on inflammatory bowel disease: An updated review

Effects of proton pump inhibitors on inflammatory bowel disease: An updated review

Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital

Diagnosis and Management of Clostridioides difficile in Inflammatory Bowel Disease

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