Clostridium difficile infection: Is there a change in the underlying factors? Inflammatory bowel disease and Clostridium difficile .

Autor: Bolukcu S; Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey., Hakyemez IN; Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey., Gultepe BS; Department of Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey., Okay G; Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey., Durdu B; Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey., Koc MM; Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey., Aslan T; Department of Infectious Diseases and Clinical Microbiology, Bezmialem Vakif University, Istanbul, Turkey.
Jazyk: angličtina
Zdroj: Saudi journal of gastroenterology : official journal of the Saudi Gastroenterology Association [Saudi J Gastroenterol] 2019 Nov-Dec; Vol. 25 (6), pp. 384-389.
DOI: 10.4103/sjg.SJG_44_19
Abstrakt: Background / Aims: Clostridium difficile is a Gram-positive, strict anaerobe, spore-forming bacterium. It can cause self-limiting mild diarrhea, severe diarrhea, pseudomembranous colitis, and fatal fulminant colitis. We aimed to investigate the changes in epidemiology and incidence of C. difficile infection in our hospital database.
Patients and Methods: Episodes of C. difficile toxin were identified in hospital database, and data such as age, sex, community versus hospital acquisition, intensive care follow-up, current or previous treatments with antibiotics within the past 3 months, medication with proton pump inhibitors, or immunosuppressive therapies were collected.
Results: Toxin-positive 78 individuals constituted the patient group. In univariate analyses, independent risk factors for toxin positivity were community versus hospital acquisition [odds ratio (OR), 5.49; 95% confidence interval (CI), 2.52-11.95; P = 0.0001], presence of inflammatory bowel diseases (IBDs) (OR, 21.5; 95% CI, 8.65-53.44; P = 0.0001), proton pump inhibitors' use (OR, 4.53; 95% CI, 1.97-10.43; P = 0.0001), immunosuppressive drug use (OR, 4.1; 95% CI, 2.01-8.3; P = 0.0001), and use of quinolone group of antibiotics (OR, 5.95; 95% CI, 1.92-18.46; P = 0.001). Antibiotic use was a protective risk factor (OR, 0.09; 95% CI, 0.01-0.78; P = 0.01) and presence of IBDs was an independent risk factor (OR, 6.8; 95% CI, 1.5-30.08; P = 0.01) in community-acquired group (OR, 0.09; 95% CI, 0.01-0.78; P = 0.01).
Conclusion: In recent studies, C. difficile infections were demonstrated to be more frequent in younger individuals who did not have a history of hospitalization but had an underlying disease such as IBD. In our study, we showed the change in the epidemiological data with prominence of underlying diseases such as IBDs.
Competing Interests: None
Databáze: MEDLINE
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