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Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital

BACKGROUND: Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is of increasing concern. This study aimed to investigate the molecular epidemiology and antimicrobial susceptibilities of toxigenic C. difficile isolated from IBD patients and to evaluate the risk...

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Autores principales: Li, Yan‐ming, Liao, Jing‐zhong, Jian, Zi‐juan, Li, Hong‐ling, Chen, Xia, Liu, Qing‐xia, Liu, Pei‐lin, Wang, Zhi‐qian, Liu, Xuan, Yan, Qun, Liu, Wen‐en
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2022
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9757003/
https://www.ncbi.nlm.nih.gov/pubmed/36397282
http://dx.doi.org/10.1002/jcla.24773
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author Li, Yan‐ming
Liao, Jing‐zhong
Jian, Zi‐juan
Li, Hong‐ling
Chen, Xia
Liu, Qing‐xia
Liu, Pei‐lin
Wang, Zhi‐qian
Liu, Xuan
Yan, Qun
Liu, Wen‐en
author_facet Li, Yan‐ming
Liao, Jing‐zhong
Jian, Zi‐juan
Li, Hong‐ling
Chen, Xia
Liu, Qing‐xia
Liu, Pei‐lin
Wang, Zhi‐qian
Liu, Xuan
Yan, Qun
Liu, Wen‐en
author_sort Li, Yan‐ming
collection PubMed
description BACKGROUND: Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is of increasing concern. This study aimed to investigate the molecular epidemiology and antimicrobial susceptibilities of toxigenic C. difficile isolated from IBD patients and to evaluate the risk factors for CDI in IBD population. METHODS: Loose or watery stools from IBD patients were tested for glutamate dehydrogenase, C. difficile toxins A&B and anaerobic culture. Toxigenic C. difficile isolates were characterized by multi‐locus sequence typing, ribotyping and antimicrobial susceptibility testing. RESULTS: The prevalence of CDI in IBD patients was 13.6% (43/317). The dominant sequence types (STs) were ST35 (20.9%), ST2 (18.6%) and ST37 (16.3%). The most common ribotypes (RTs) were RT 017 (18.6%), RT 012 (14.0%), and RT 220 (14.0%), whereas RT 027 and RT 078 were not detected in this study. All the isolates were susceptible to vancomycin and metronidazole. The multidrug resistance rate of C. difficile RT 017 was higher (p < 0.01) than that of other RT strains. Recent hospitalization, use of corticosteroids and proton pump inhibitors were related to increased risk of CDI in IBD patients; of these, recent hospitalization and proton pump inhibitors use were independent risk factors. CONCLUSION: Patients with IBD have a relatively high incidence rate of CDI. C. difficile RT 017 is most frequently isolated from IBD patients in this region and warrants more attention to its high resistance rate. Clinicians should pay greater attention to CDI testing in IBD patients with diarrhea to ensure early diagnosis and initiation of effective treatment.
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spelling pubmed-97570032022-12-20 Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital Li, Yan‐ming Liao, Jing‐zhong Jian, Zi‐juan Li, Hong‐ling Chen, Xia Liu, Qing‐xia Liu, Pei‐lin Wang, Zhi‐qian Liu, Xuan Yan, Qun Liu, Wen‐en J Clin Lab Anal Research Articles BACKGROUND: Clostridioides difficile infection (CDI) in patients with inflammatory bowel disease (IBD) is of increasing concern. This study aimed to investigate the molecular epidemiology and antimicrobial susceptibilities of toxigenic C. difficile isolated from IBD patients and to evaluate the risk factors for CDI in IBD population. METHODS: Loose or watery stools from IBD patients were tested for glutamate dehydrogenase, C. difficile toxins A&B and anaerobic culture. Toxigenic C. difficile isolates were characterized by multi‐locus sequence typing, ribotyping and antimicrobial susceptibility testing. RESULTS: The prevalence of CDI in IBD patients was 13.6% (43/317). The dominant sequence types (STs) were ST35 (20.9%), ST2 (18.6%) and ST37 (16.3%). The most common ribotypes (RTs) were RT 017 (18.6%), RT 012 (14.0%), and RT 220 (14.0%), whereas RT 027 and RT 078 were not detected in this study. All the isolates were susceptible to vancomycin and metronidazole. The multidrug resistance rate of C. difficile RT 017 was higher (p < 0.01) than that of other RT strains. Recent hospitalization, use of corticosteroids and proton pump inhibitors were related to increased risk of CDI in IBD patients; of these, recent hospitalization and proton pump inhibitors use were independent risk factors. CONCLUSION: Patients with IBD have a relatively high incidence rate of CDI. C. difficile RT 017 is most frequently isolated from IBD patients in this region and warrants more attention to its high resistance rate. Clinicians should pay greater attention to CDI testing in IBD patients with diarrhea to ensure early diagnosis and initiation of effective treatment. John Wiley and Sons Inc. 2022-11-17 /pmc/articles/PMC9757003/ /pubmed/36397282 http://dx.doi.org/10.1002/jcla.24773 Text en © 2022 The Authors. Journal of Clinical Laboratory Analysis published by Wiley Periodicals LLC. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) License, which permits use and distribution in any medium, provided the original work is properly cited, the use is non‐commercial and no modifications or adaptations are made.
spellingShingle Research Articles
Li, Yan‐ming
Liao, Jing‐zhong
Jian, Zi‐juan
Li, Hong‐ling
Chen, Xia
Liu, Qing‐xia
Liu, Pei‐lin
Wang, Zhi‐qian
Liu, Xuan
Yan, Qun
Liu, Wen‐en
Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital
title Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital
title_full Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital
title_fullStr Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital
title_full_unstemmed Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital
title_short Molecular epidemiology and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital
title_sort molecular epidemiology and clinical characteristics of clostridioides difficile infection in patients with inflammatory bowel disease from a teaching hospital
topic Research Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9757003/
https://www.ncbi.nlm.nih.gov/pubmed/36397282
http://dx.doi.org/10.1002/jcla.24773
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