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.

Clostridium difficile and Pediatric Inflammatory Bowel Disease / Martinelli, Massimo; Strisciuglio, Caterina; Gabor, Veres; Anders, Paerregaard; Pavic, Ana M.; Marina, Aloi; Javier Martín de Carpi, ; Arie, Levine; Dan, Turner; Mariassunta Del Pezzo, ; Staiano, Annamaria; Miele, Erasmo. - In: INFLAMMATORY BOWEL DISEASES. - ISSN 1078-0998. - 20:12(2014), pp. 2219-2225. [10.1097/MIB.0000000000000219]

Clostridium difficile and Pediatric Inflammatory Bowel Disease

Massimo Martinelli;STRISCIUGLIO, CATERINA;STAIANO, ANNAMARIA;MIELE, ERASMO
2014

Abstract

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.
2014
Clostridium difficile and Pediatric Inflammatory Bowel Disease / Martinelli, Massimo; Strisciuglio, Caterina; Gabor, Veres; Anders, Paerregaard; Pavic, Ana M.; Marina, Aloi; Javier Martín de Carpi, ; Arie, Levine; Dan, Turner; Mariassunta Del Pezzo, ; Staiano, Annamaria; Miele, Erasmo. - In: INFLAMMATORY BOWEL DISEASES. - ISSN 1078-0998. - 20:12(2014), pp. 2219-2225. [10.1097/MIB.0000000000000219]
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Utilizza questo identificativo per citare o creare un link a questo documento: https://hdl.handle.net/11588/610898
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