S1145 Long-Term Impact of Clostridium difficile On Inflammatory Bowel Disease

Chiplunker, Adeeti; Ananthakrishnan, Ashwin N.; Beaulieu, Dawn B.; Naik, Amar S.; Zadvornova, Yelena; Skaros, Susan; Johnson, Kristen; Perera, Lilani P.; Binion, David G.; Issa, Mazen

doi:10.1016/s0016-5085(09)60894-5

Cited by 13 publications

(9 citation statements)

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“…Long-term outcomes have been reported by few studies (27,(47)(48)(49). Two studies (27,47) showed an increased number of visits to the emergency room, more UC-related hospitalizations, and higher colectomy rates than in those with UC alone in the year following initial infection.…”

Section: Discussionmentioning

confidence: 99%

“…Two studies (27,47) showed an increased number of visits to the emergency room, more UC-related hospitalizations, and higher colectomy rates than in those with UC alone in the year following initial infection. In addition, over half of UC patients had an escalation in medical therapy one year following CDI (47,49). Recently, a retrospective study on UC hospitalized patients with and without CDI found that those with CDI had a higher adjusted 5-year risk of mortality (48).…”

Section: Discussionmentioning

confidence: 99%

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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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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Clostridium difficile infection and inflammatory bowel disease

Cojocariu

Stanciu

Stoica³

et al. 2020

Turk J Gastroenterol

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“…It is also possible that Clostridium difficile is able to alter the natural history of IBD by modifying mucosal immune mechanisms and/or the gut microbiome. Indirect support for this concept has been demonstrated by studies, which found an increased risk of readmission and requirement for escalation in immunosuppressive therapy in IBD patients following CDI . An equally plausible explanation is that CDI is simply a surrogate marker of underlying IBD severity; whereby patients with a severe phenotype are more likely to acquire CDI through repeated hospitalisations, antibiotic exposure, extensive colonic IBD, reduced microbial diversity from active inflammation and exposure to immunosuppressive medications .…”

Section: Discussionmentioning

confidence: 99%

Systematic review with meta‐analysis: the impact of Clostridium difficile infection on the short‐ and long‐term risks of colectomy in inflammatory bowel disease

Law

Tariq

Khanna

et al. 2017

Aliment Pharmacol Ther

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“…Forty-six percent of patients had more hospitalizations in the year after their initial CDI episode compared with the preceding year, and recurrent CDI occurred in 11.5% of patients; colectomy was required in 10.3% of patients. 51 Ananthakrishnan et al 52 showed that there were certain predictors that portended to a worse outcome in IBD patients who develop CDI: albumin <3 g/dL, hemoglobin <9 g/dL, and serum creatinine >1.5 mg/dL were predictors of severe outcomes, defined as time to colectomy and death, of hospitalized IBD patients with CDI. The impact of CDI on UC, specifically, has also been studied.…”

Section: Discussionmentioning

confidence: 99%

Clostridium difficile Infection and Inflammatory Bowel Disease

Reddy

Brandt²

2013

Journal of Clinical Gastroenterology

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The prevalence of Clostridium difficile infection (CDI) in inflammatory bowel disease (IBD) has become a focus of increased attention, as the C. difficile epidemic continues to grow. Although first documented more than 20 years ago, only in recent years has the relationship between these 2 entities been better clarified, and recent epidemiologic studies have shown that IBD patients are at increased susceptibility for CDI compared with the general population. Despite this increased attention, much still remains unknown, and the overlapping clinical presentations of CDI and IBD pose barriers to diagnosis and standardized treatment. Moreover, given the relationship between mortality and severity of CDI in IBD patients, early recognition of those who are at increased risk for infection is of paramount importance to improve patient outcome.

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S1145 Long-Term Impact of Clostridium difficile On Inflammatory Bowel Disease

Cited by 13 publications

References 0 publications

Clostridium difficile infection and inflammatory bowel disease

Clostridium difficile infection and inflammatory bowel disease

Systematic review with meta‐analysis: the impact of Clostridium difficile infection on the short‐ and long‐term risks of colectomy in inflammatory bowel disease

Clostridium difficile Infection and Inflammatory Bowel Disease

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