炎症性肠道疾病的较高疾病活性使人倾向于 Clostridioides difficile感染
Krista Vitikainen1, Merit Kase2, Leo Meriranta2
1HUS Helsinki University Hospital, Haartmaninkatu 4, P.O. Box 340, Helsinki 00029, Finland.
活跃的炎症性肠病 (IBD) 和最近的诊断增加了Clostridioides difficile感染 (CDI) 的风险. 有活跃IBD的患者可能会从更密切的监测中受益,以防止CDI.
科学领域:
- 胃肠病学 胃肠病学
- 传染性疾病 传染性疾病
- 临床医学 临床医学
背景情况:
- 艰难结肠杆菌感染 (CDI) 在治疗炎症性肠病 (IBD) 患者方面具有重大挑战,往往导致不良后果.
- 确定CDI及其IBD患者复发的特定风险因素对于改善患者护理至关重要.
研究的目的:
- 确定与诊断为IBD的患者中CDI发展相关的临床风险因素.
- 调查IBD患者中导致复发性CDI (rCDI) 的因素.
主要方法:
- 进行了一项病例控制队列研究,涉及279名患有CDI的IBD患者.
- 在CDI诊断前三个月内,患者的病史和IBD症状与没有CDI的年龄和性别匹配的IBD患者进行了比较.
- 感染后2-6个月内,对IBD患者的CDI结果进行了监测.
主要成果:
- 活跃的IBD,特别是性结肠炎 (UC) 和结肠类克罗恩病,先于CDI. 最近被诊断出IBD和皮质类固醇使用被确定为显著的风险因素.
- 复发性CDI (rCDI) 影响了30%的IBD患者,67%的复发发生在90天内. 大多数rCDI患者 (79%) 有UC.
- 通过增加医疗治疗升级和住院治疗,CDI复杂化了IBD,但并没有增加胆管切除风险.
结论:
- 在IBD中CDI的关键风险因素包括活跃疾病,UC,结肠克罗恩病,短时间IBD,皮质类固醇使用和住院治疗.
- 有活跃IBD和较短疾病持续时间的患者需要对早期CDI检测和管理进行警监测.
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