Clostridium Difficile Associated Diarrhœa: A Role in Inflammatory Bowel Disease?

Bolton, R P; Sherriff, R. J.; Read, A. E.

doi:10.1016/s0140-6736(80)90940-x

Cited by 130 publications

(40 citation statements)

References 11 publications

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“…This predisposes the patient to infection with C. difficile [21,22, ampicillin, clindamycin, and cephalosporins, is associated with C. difficile disease [2,12,20,29,49,50,93,[121][122][123][124][125]. 138].…”

Section: Endoscopymentioning

confidence: 99%

Clostridium difficile Infection: Risk Factors, Medical and Surgical Management

Klingler¹,

Metzger²,

Seelig³

et al. 2000

Dig Dis

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Background:Clostridium difficile has become recognized as a cause of nosocomial infection which may progress to a fulminant disease. Methods: Literature review using electronic literature research back to 1966 utilizing Medline and Current Contents. All publications on antibiotic-associated diarrhea, antibiotic-associated colitis, and pseudomembranous colitis as well as C. difficile infection were included. We addressed established and potential risk factors for C. difficile disease such as an impaired immune system and cost benefits of different diagnostic tests. An algorithm is outlined for diagnosis and both medical and surgical management of mild, moderate and severe C. difficile disease. Results: Diagnosis of C. difficile infection should be suspected in patients with diarrhea, who have received antibiotics within 2 months or whose symptoms started after hospitalization. A stool specimen should be tested for the presence of leukocytes and C. difficile toxins. If this is negative and symptoms persist, stool should be tested with ‘rapid’ enzyme immunoabsorbent and stool cytotoxin assays, which are the most cost-effective tests. Endoscopy and other imaging studies are reserved for severe and rapidly progressive courses. Oral metronidazole or vancomycin are the antibiotics of choice. Surgery is rarely required for selected patients refractory to medical treatment. The threshold for surgery in severe cases with risk factors including an impaired immune system should be low. Conclusion:C. difficile infection has been recognized with increased frequency as a nosocomial infection. Early diagnosis with immunoassays of the stool and prompt medical therapy have a high cure rate. Metronidazole has supplanted oral vancomycin as the drug of first choice for treating C. difficile infections.

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Section: Endoscopymentioning

confidence: 99%

Clostridium difficile Infection: Risk Factors, Medical and Surgical Management

Klingler¹,

Metzger²,

Seelig³

et al. 2000

Dig Dis

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“…Both these conditions have been related to the use of antimicrobial agents (Bartlett et al 1979), however this is not always the case (Wald, Mendelow & Bartlett, 1980;Howard, Sullivan & Troster, 1980) and the significance of C. difficile in other forms of diarrhoea is still being debated (Falsen et al 1980;Bolton, Sheriff & Read, 1980;Brettle et al 1982).…”

Section: Introductionmentioning

confidence: 99%

Clostridium difficilein general practice and community health

Riley

Wymer

Bamford

et al. 1986

J. Hyg.

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SUMMARYThe isolation rate for Clostridium difficile in diarrhceal stools was investigated in patients from general practice and community health centres over a 14-month period. C. difficile or its cytotoxin was detected in specimens from 89 (4 7 00) of 1882 patients studied and accounted for 30 3 Qo of all enteropathogenic micro-organisms isolated. Overall C. difficile was second only to Giandia lamblia in frequency.

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“…An association of PMC with inflamma tory bowel disease has been reported [12,13]. Although this woman had a family history' of Crohn's disease, there was no evidence of inflammatory bowel disease despite exten sive investigation.…”

Section: Discussionmentioning

confidence: 79%

Recurrent Clostridium difficile-Associated Colitis Responding to Cholestyramine

Kunimoto¹,

Thomson²

1986

Digestion

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Clostridium Difficile Associated Diarrhœa: A Role in Inflammatory Bowel Disease?

Cited by 130 publications

References 11 publications

<i>Clostridium difficile </i>Infection: Risk Factors, Medical and Surgical Management

<i>Clostridium difficile </i>Infection: Risk Factors, Medical and Surgical Management

Clostridium difficilein general practice and community health

Recurrent <i>Clostridium difficile-</i>Associated Colitis Responding to Cholestyramine

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