The Diagnostic Yield of Stool Pathogen Studies During Relapses of Inflammatory Bowel Disease

Meyer, Alyssa J.; Ramzan, Nizar N.; Loftus, Edward V.; Heigh, Russell I.; Leighton, Jonathan A.

doi:10.1097/01.mcg.0000139057.05297.d6

Cited by 123 publications

(78 citation statements)

References 22 publications

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“…Second, the rate of bacterial intestinal infections in patients with active IBD is around 10%; although our figures were the lowest, they were very close to those reported by Baliellas et al [13] in a study performed in the same geographic area. Third, the most frequent enteropathogenic bacteria isolated in stool cultures was C. jejuni [13,14,15]. This was recently highlighted in a prospective Bulgarian study in which C. jejuni infections were specifically evaluated by conventional stool culture among 70 IBD patients, resulting in a positivity rate of 6.2% and 3.7% in CD and UC patients, respectively [16].…”

Section: Discussionmentioning

confidence: 99%

See 1 more Smart Citation

Prospective, Observational, Cross-Sectional Study of Intestinal Infections among Acutely Active Inflammatory Bowel Disease Patients

Navarro-Llavat¹,

Domènech

Bernal³

et al. 2009

Digestion

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Background: Intestinal infections have been claimed to precipitate or aggravate flares of inflammatory bowel disease (IBD). The reported incidence of such infections among IBD patients varies between 9 and 13%, but only a few prospective studies have been conducted. Aims: To evaluate the incidence of intestinal infections by enteropathogens in patients with active IBD, their impact on clinical outcome, and to identify associated risk factors. Patients and Methods: Consecutive patients admitted because of a relapse or suspected onset of IBD were prospectively included. At admittance, stool samples for culture, examination for intestinal parasites, and cytotoxin assay for Clostridium difficile were collected. Baseline clinical characteristics, potential risk factors for gastrointestinal infections, and clinical outcome were recorded. Results: Ninety-nine episodes were included. Six intestinal infections were diagnosed in 6 patients (5 ulcerative colitis, 1 ileocolonic Crohn’s disease), Campylobacter jejuni being the most frequent isolated microbe (n = 5). None of the patients with intestinal infection needed surgery, but two of them required second-line therapies. Conclusions: Gastrointestinal infections among IBD patients do not exceed 10% and occur mostly in patients with extensive involvement of the colon. Infection by enteropathogenic bacteria does not appear to be associated with a poorer clinical outcome of the IBD flare.

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Section: Discussionmentioning

confidence: 99%

“…Positive stool culture resulted positive in 6 cases (8.9%). Finally, two retrospective studies assessing the incidence of positive stool cultures and/or fecal C. difficile toxins among IBD patients [14, 15] reported an incidence of 19 and 10.5%, respectively. Our results agree with some of the findings in previous studies.…”

Section: Discussionmentioning

confidence: 99%

Prospective, Observational, Cross-Sectional Study of Intestinal Infections among Acutely Active Inflammatory Bowel Disease Patients

Navarro-Llavat¹,

Domènech

Bernal³

et al. 2009

Digestion

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“…A similar increase in CDI rate in IBD patients (1.8% in 2004 and 4.6% in 2005, p<0.01) was reported by Issa et al (8) from a tertiary care center in Wisconsin. Studies from two other academic USA centers, one in Mount Sinai Hospital, New York (27) and the second in Mayo Clinic, Scottsdale, Arizona, reported that of their IBD patients admitted with flares 47% and 20%, respectively had CDI (29). The increasing rates of CDI among IBD patients reported from single tertiary care centers in USA has also been noted in Europe and other geographic regions (10,30).…”

Section: Introductionmentioning

confidence: 83%

“…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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“…There was a significant association between infection and the need for hospital admission. In another study, Meyer et al [6] evaluated 54 IBD patients during 62 relapses with 99 stool samples. Twelve stool tests were positive for enteric infections.…”

Section: Dear Sirmentioning

confidence: 99%

Fucidic Acid Use in Metronidazole Nonresponders with Clostridium difficile Infection

Bektaş¹,

Törüner²,

Çetinkaya³

et al. 2007

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The Diagnostic Yield of Stool Pathogen Studies During Relapses of Inflammatory Bowel Disease

Abstract: Stool studies yielded a pathogen, mainly C. difficile, in 20% of the relapsing IBD patients. Antibiotic use was significantly associated with a positive C. difficile toxin. Toxin-positive patients improved clinically with targeted antibiotics.

Cited by 123 publications

References 22 publications

Prospective, Observational, Cross-Sectional Study of Intestinal Infections among Acutely Active Inflammatory Bowel Disease Patients

Prospective, Observational, Cross-Sectional Study of Intestinal Infections among Acutely Active Inflammatory Bowel Disease Patients

Clostridium difficile infection and inflammatory bowel disease

Fucidic Acid Use in Metronidazole Nonresponders with Clostridium difficile Infection

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