Abstract
Aim. To study epidemiology and risk factors for Clostridium infection (CDI) associated with Clostridium difficile in patients with inflammatory bowel disease (IBD). Materials and methods. 1179 medical records were analyzed in a retrospective study of patients with IBD, of which 764 patients met the inclusion criteria. Patients were divided into 2 groups based on the presence of a preliminary diagnosis of CDI. Statistical analysis was carried out using Pearson Chi-square and two-sample t-test. Results. The incidence of CDI in patients with IBD was 17.3%, with the same prevalence in patients with Crohn's disease (CD) (n=53/40.1%) and ulcerative colitis (UC) (n=79/59.9%). The mean age of occurrence of CDI in patients with IBD was 37.8±12.9, 84.8% of infections were community-acquired and only 4.5% occurred in medical institutions. Only 21.2% of all patients with CDI had a history of antibiotic use, and 24.2% had previously used steroids. Long-term immunosuppressive therapy in patients with IBD has an impact on the development of CDI: among patients with CDI 45.5% long-term received azathioprine/6-mercaptopurine, in patients without IBD - 17.7% (p
Highlights
The study shows that patients with inflammatory bowel disease (IBD) are more sensitive to the development of Clostridium infection (CDI) at a young age, while not having such traditional risk factors as recent hospitalization or antibiotic use
Gastroenterology Research and Practice Volume. 2017; Article ID 4803262:5. https://doi.org/10.1155/ 2017/4803262
Summary
ÃÁÓÇ «Ìîñêîâñêèé êëèíè÷åñêèé íàó÷íî-ïðàêòè÷åñêèé öåíòð èìåíè À.Ñ. Ëîãèíîâà» Äåïàðòàìåíòà çäðàâîîõðàíåíèÿ ãîðîäà Ìîñêâû, Ìîñêâà, Ðîññèÿ. Ðåçþìå Öåëü – èçó÷èòü ýïèäåìèîëîãèþ è ôàêòîðû ðèñêà âîçíèêíîâåíèÿ êëîñòðèäèàëüíîé èíôåêöèè (ÊÄÈ), ñâÿçàííîé ñ Clostridium difficile ó ïàöèåíòîâ ñ âîñïàëèòåëüíûìè çàáîëåâàíèÿìè êèøå÷íèêà (ÂÇÊ). ×àñòîòà ÊÄÈ ñðåäè ïàöèåíòîâ ñ ÂÇÊ ñîñòàâèëà 17,3%, ïðè ýòîì âûÿâëåíà îäèíàêîâàÿ ðàñïðîñòðàíåííîñòü ÊÄÈ ó áîëüíûõ áîëåçíüþ Êðîíà (ÁÊ; n=53/40,1%) è ÿçâåííûì êîëèòîì (ßÊ; n=79/59,9%). Ñðåäíèé âîçðàñò âîçíèêíîâåíèÿ ÊÄÈ ó ïàöèåíòîâ ñ ÂÇÊ ñîñòàâèë 37,8±12,9 ãîäà, ïðè ýòîì 84,8% èíôåêöèé áûëè âíåáîëüíè÷íûìè è òîëüêî 4,5% âîçíèêëè â ìåäèöèíñêèõ ó÷ðåæäåíèÿõ. Ó 21,2% ïàöèåíòîâ ñ ÂÇÊ ñ ÊÄÈ â àíàìíåçå áûëè óêàçàíèÿ íà èñïîëüçîâàíèå àíòèáèîòèêîâ, à 24,2% ðàíåå ïðèìåíÿëè ñòåðîèäû. Êîíòðîëèðîâàòü çàáîëåâàíèÿ ñ ïîìîùüþ òåðàïèè ñàëèöèëàòàìè ìîãëè 18% ïàöèåíòîâ ñ ÂÇÊ ñ ÊÄÈ, â òî âðåìÿ êàê 62% ïàöèåíòîâ áåç ÊÄÈ äîñòèãàëè ðåìèññèè çàáîëåâàíèÿ, ïðèíèìàÿ ñàëèöèëàòû (p
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