Clostridium difficile and pediatric inflammatory bowel disease: A prospective, comparative, multicenter, ESPGHAN study
Autor: | Dan Turner, Erasmo Miele, Gábor Veres, Marina Aloi, Massimo Martinelli, Mariassunta Del Pezzo, Ana Močić Pavić, Anders Paerregaard, Arie Levine, Javier Martín-de-Carpi, Annamaria Staiano, Caterina Strisciuglio |
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Přispěvatelé: | Martinelli, Massimo, Strisciuglio, Caterina, Veres, Gabor, Paerregaard, Ander, Pavic, Ana M., Aloi, Marina, Martín De Carpi, Javier, Levine, Arie, Turner, Dan, Del Pezzo, Mariassunta, Staiano, Annamaria, Miele, Erasmo |
Jazyk: | angličtina |
Rok vydání: | 2014 |
Předmět: |
Male
medicine.medical_specialty Proton Pump Inhibitor Adolescent Prognosi MEDLINE Clostridium Infection Disease digestive system Gastroenterology Inflammatory bowel disease Follow-Up Studie Disease course Internal medicine Anti-Bacterial Agent medicine Humans Immunology and Allergy Prospective Studies Child Prospective cohort study Crohn's disease Ulcerative coliti Clostridium difficile Ulcerative colitis Anti-Bacterial Agents Celiac Disease Child Preschool Clostridium Infections Female Follow-Up Studies Inflammatory Bowel Diseases Prognosis Proton Pump Inhibitors Medicine (all) Clostridioides difficile business.industry Inflammatory Bowel Disease medicine.disease digestive system diseases Prospective Studie business Human |
Popis: | Background: Clostridium difficile infection is associated with pediatric inflammatory bowel disease (IBD) in several ways. We sought to investigate C. difficile infection in pediatric patients with IBD in comparison with a group of children with celiac disease and to evaluate IBD disease course of C. difficile infected patients. Methods: In this prospective, comparative, multicenter study, 211 pediatric patients with IBD were enrolled from October 2010 to October 2011 and tested for the presence of C. difficile toxins A and B in their stools at 0, 6, and 12 months. During the same study period, stool specimens for C. difficile toxins analysis were collected from 112 children with celiac disease as controls. Results: Clostridium difficile occurrence was significantly higher in patients with IBD compared with patients with celiac disease (7.5% versus 0.8%; P = 0.008). Clostridium difficile was associated with active disease in 71.4% of patients with IBD (P = 0.01). Colonic involvement was found in 85.7% of patients with C. difficile. Antibiotics, proton pump inhibitors, hospitalization, and IBD therapies were not associated with increased C. difficile detection. At 12 months, a higher number of C. difficile-positive patients at the enrollment started immunosuppressant/biological therapy compared with patients without C. difficile (P = 0.01). At 6 and 12 months, patients with C. difficile were more frequently in active disease than patients without C. difficile (P = 0.04; P = 0.08, respectively). Hospitalizations were higher at 6 months in C. difficile group (P = 0.05). Conclusions: In conclusion, this study demonstrates that pediatric IBD is associated with increased C. difficile detection. Patients with C. difficile tend to have active colonic disease and a more severe disease course. Copyright © 2014 Crohn's & Colitis Foundation of America, Inc. |
Databáze: | OpenAIRE |
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