Incidence and Outcome of Clostridium difficile Infection in Hospitalized Patients with Inflammatory Bowel Disease in the UK
| Autor: | Neerav M. Joshi, Isobel H Marks, David Ball, Richard Crowson, David S. Rampton |
|---|---|
| Rok vydání: | 2016 |
| Předmět: |
Male
medicine.medical_specialty genetic structures Hospitalized patients digestive system Gastroenterology Inflammatory bowel disease 03 medical and health sciences 0302 clinical medicine Internal medicine Epidemiology Humans Medicine In patient Enterocolitis Pseudomembranous Aged Clostridioides difficile business.industry Incidence Incidence (epidemiology) Hazard ratio Case-control study General Medicine Length of Stay Middle Aged Clostridium difficile Inflammatory Bowel Diseases medicine.disease United Kingdom digestive system diseases Hospitalization Case-Control Studies 030220 oncology & carcinogenesis Female 030211 gastroenterology & hepatology business |
| Zdroj: | Journal of Crohn's and Colitis. 11:70-76 |
| ISSN: | 1876-4479 1873-9946 |
| DOI: | 10.1093/ecco-jcc/jjw117 |
| Popis: | Background and aims: Previous studies have reported that Clostridium difficile infection [CDI] is more common, and has a worse outcome, in patients with inflammatory bowel disease [IBD] than in those without. We have now reassessed the incidence and outcome of CDI in in-patients with and without IBD, and the outcomes of admissions for IBD patients with and without CDI. Methods: In-patients who had stool samples submitted for C. difficile testing [2007–2013] were collated. Two matched pools were generated: patients with IBD and CDI vs non-IBD patients with CDI [matched for age, sex and date] and patients with IBD and CDI vs IBD patients without CDI [matched for age and IBD type]. For each group, admission details, pre-admission and outcome data were compared. Results: Four per cent [1079/21035] of samples were positive for CDI; 5% [49] of these were from IBD in-patients. The incidence of CDI in IBD patients decreased from 8.7% in 2007/08 to 0.4% in 2012/13 [ p < 0.0001]. Length of stay was shorter in IBD patients with CDI than in non-IBD CDI patients (hazard ratio [HR] 0.335 [0.218–0.513]) and was no different between IBD patients with and without CDI (HR 0.661 [0.413–1.06]). IBD patients were diagnosed with CDI earlier in their admission than non-IBD patients (HR 0.182 [0.093–0.246]). No differences in mortality were found. Conclusions: The incidence of CDI complicating IBD has fallen since 2007. CDI is no longer associated with worse short-term outcomes in patients with IBD than in those without. Patients with CDI and IBD have similar outcomes to those with IBD alone. |
| Databáze: | OpenAIRE |
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