Clostridium difficile and inflammatory bowel disease: Role in pathogenesis and implications in treatment

作     者：Orna Nitzan Mazen Elias Bibiana Chazan Raul Raz Walid Saliba 

作者机构：Infectious Disease UnitHa’emek Medical CenterAfula 18101Israel Bruce Rappaport Faculty of MedicineTechnion-Israel Institute of TechnologyHaifa 31096Israel Department of Internal Medicine CHa’emek Medical CenterAfula 18101Israel 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2013年第19卷第43期

页      面：7577-7585页

核心收录：

学科分类：1002[医学-临床医学] 100201[医学-内科学(含：心血管病、血液病、呼吸系病、消化系病、内分泌与代谢病、肾病、风湿病、传染病)] 10[医学] 

主　　题：Clostridium difficile Diarrhea Inflammatory bowel disease Pathogenesis Treatment 

摘      要：Clostridium difficile(***)is the leading cause of antibiotic associated colitis and nosocomial *** with inflammatory bowel disease(IBD)are at increased risk of developing *** infection(CDI),have worse outcomes of CDI-including higher rates of colectomy and death,and experience higher rates of ***,it is still not clear whether *** is a cause of IBD or a consequence of the inflammatory state in the intestinal *** burden of CDI has increased dramatically over the past decade,with severe outbreaks described in many countries,which have been attributed to a new and more virulent strain.A parallel rise in the incidence of CDI has been noted in patients with *** patients with CDI tend be younger,have less prior antibiotic exposure,and most cases of CDI in these patients represent outpatient acquired *** clinical presentation of CDI in these patients can be unique-including diversion colitis,enteritis and pouchitis,and typical findings on colonoscopy are often *** to the high prevalence of CDI in patients hospitalized with an IBD exacerbation,and the prognostic implications of CDI in these patients,it is recommended to test all IBD patients hospitalized with a disease flare for *** includes general measures such as supportive care and infection control *** therapy with either oral metronidazole,vancomycin,or the novel antibiotic-fidaxomicin,should be initiated as soon as *** macrobiota transplantation constitutes another optional treatment for severe/recurrent *** aim of this paper is to review recent data on CDI in IBD:role in pathogenesis,diagnostic methods,optional treatments,and outcomes of these patients.