<i>Clostridium difficile</i> in Inflammatory Bowel Disease: A Retrospective Study

Gillespie, William; Marya, Neil B.; Fahed, Julien; Leslie, Gregory; Patel, Krunal; Cave, David R.

doi:10.1155/2017/4803262

Cited by 23 publications

(23 citation statements)

References 28 publications

(31 reference statements)

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“…However, the existing data from other countries indicate a significantly lower incidence of CDI (2.8–11.1%) in adult UC patients compared to our findings [17, 32]. Recent studies from Europe, Canada, and the United States suggesting a rate of 20–27% community-acquired CDI in the general population [33]. Other recent studies have reported that in the majority of IBD patients, CDI was contracted outside of the hospital and 47.2% of patients acquired CDI from the community [34].…”

Section: Discussioncontrasting

confidence: 69%

“…We found a significant relationship between the presence of CDI and steroid treatment, previous surgery, the severity of UC and anti-inflammatory treatment (Table 2). Previous studies have demonstrated that in UC patients, CDI is prevalent and colonic complicity, female, recent surgery, colectomy, younger age, and systemic steroid therapy was independently associated with CDI [8, 17, 23, 33–35]. Fourteen percent of our patients showed one or two episodes of recurrences during the study period.…”

Section: Discussionmentioning

confidence: 52%

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Clostridium difficile isolated from faecal samples in patients with ulcerative colitis

et al. 2019

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Background Ulcerative colitis (UC) is an inflammatory bowel disease (IBD) that is widely identified worldwide. This study aimed to investigate the phenotypic characterization and molecular typing of Clostridium difficile isolates among patients with UC at an inflammatory bowel disease clinic in Iran. Methods In this cross-sectional study, conducted from April 2015 to December 2015, 85 UC patients were assessed for C.difficile infection (CDI). C. difficile isolates were characterized based on their toxin profile and antimicrobial resistance pattern. Multi-locus sequence typing analysis (MLST) and PCR ribotyping were performed to define the genetic relationships between different lineages of toxigenic strains. Results The prevalence of C. difficile isolates was 31.8% (27/85) in patients, of those 15 patients (17.6%) had CDI. Three different sequence types (STs) identified based on MLST among the toxigenic isolates, that is ST54 (33.3%), ST2 (53.3%), and ST37 (13.6%). C. difficile strains were divided into four different PCR-ribotypes (012, 014, 017 and IR1). The most common ribotype was 014 accounting for 48.3% (7/15) of all strains. The strains isolated during the first episode and recurrence of CDI usually belonged to PCR ribotype 014 (ST2). A high rate of CDI recurrence (14.1%, 12/85) experienced in UC patients. Colonization of the gastrointestinal tract with non-toxigenic C. difficile strains was frequent among patients with mild disease. All C. difficile isolates were susceptible to metronidazole, and vancomycin, 86 and 67% of isolates were resistant to clindamycin and erythromycin respectively. There was no correlation between the toxin type and antibiotic resistance ( p > 0.05). Conclusion Overall CDI is rather prevalent in UC patients. All patients with CDI experienced moderate to severe disease and exposed to different antimicrobial and anti-inflammatory agents. Close monitoring and appropriate management including early detection and fast treatment of CDI will improve UC outcomes. Electronic supplementary material The online version of this article (10.1186/s12879-019-3965-8) contains supplementary material, which is available to authorized users.

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Section: Discussioncontrasting

confidence: 69%

Section: Discussionmentioning

confidence: 52%

Clostridium difficile isolated from faecal samples in patients with ulcerative colitis

et al. 2019

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“…Their results showed that incidence of CDI among IBD patients was 6.7% with equal prevalence of CDI among CD and UC, concluding that IBD patients are more vulnerable to CDI at a younger age and that IBD patients with CDI would require biologic therapy with increased rates of extra-intestinal manifestations. [26] These results are in agreement with our results, where some patients with both IBD & CDI had extra-intestinal manifestations (arthritis, uveitis, episcleritis or erythema nodosum).…”

Section: Clostridia Difficilesupporting

confidence: 93%

Clostridium Difficile Infection in Inflammatory Bowel Disease; Does it Have an Impact?

Sabet

Elbanna

Bedewy

et al. 2020

Afro-Egyptian Journal of Infectious and Endemic Diseases

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“…It was reported that IBD patients with C. difficile infections (CDI), manifest severe clinical symptoms; including, abdominal pain, diarrhea, bloody stools, and leukocytosis . According to the reports, high prevalence of CDI in patients with IBD was revealed . Evidently, the toxins produced by this bacteria, inactivate the Rho family proteins which are involved in intracellular signaling pathways .…”

Section: Ibd and Clostridium Difficilementioning

confidence: 99%

The role of bacteria in the inflammatory bowel disease development: a narrative review

Azimi

Nasiri

Chirani

et al. 2018

APMIS

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Inflammatory bowel disease (IBD) is a general term used for the ulcerative colitis (UC) and Crohn's disease (CD); in addition, IBD principally refers to a chronic disease of the gastrointestinal tract in which mediated by immune system. Consequently, IBD could progress in individuals who are genetically prone. Infections role in the development of inflammatory disease of the gastrointestinal tract has been studied by quite many clinical studies; furthermore, the possible role of some pathogens in the development and exacerbation of the inflammatory disease of the gastrointestinal tract have been described. Evidently, the most indispensable pathogens that could be associated with the IBD disease, Mycobacterium avium subspecies paratuberculosis, Clostridium difficile, Escherichia coli, Listeria monocytogenes, Campylobacter concisus; as well as viruses, such as, cytomegalovirus, Epstein-Barr Virus, and measles virus are notable. A number of pathogenic parasites may also be involved in the development and progression of the disease. As a matter of fact, overexposure of immune system in the presence of excessive bacterial substances could also lead to the loss of immunological tolerance to the bacteria, which are commonly considered as the normal flora in the intestine; furthermore, it may subsequently elicit bowel inflammation and IBD development. In the current study, we discussed the most common bacterial pathogens that may be involved in the development of IBD; as well as, a comprehensive narrative review related to the evidences which support or ignore the possible role of bacteria in progression of IBD, indeed.

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Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study

Cited by 23 publications

References 28 publications

Clostridium difficile isolated from faecal samples in patients with ulcerative colitis

Clostridium difficile isolated from faecal samples in patients with ulcerative colitis

Clostridium Difficile Infection in Inflammatory Bowel Disease; Does it Have an Impact?

The role of bacteria in the inflammatory bowel disease development: a narrative review

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