Impact of Clostridioides difficile Infection on the Outcome of Severe Flare of Ulcerative Colitis.

IF 2.8 4区医学 Q2 GASTROENTEROLOGY & HEPATOLOGY

Journal of clinical gastroenterology Pub Date : 2025-05-12 DOI:10.1097/MCG.0000000000002196

Anupam Kumar Singh, Siddharth Shukla, Ritesh Acharya, Chhagan Lal Birda, Pramod Kumar Sah, Shravya Singh, Vaneet Jearth, Jimil Shah, Ashish Agarwal, Arun Kumar Sharma, Yashwant Raj Sakaray, Saroj Kant Sinha, Usha Dutta

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引用次数: 0

Abstract

Background: Clostridioides difficile infection (CDI) and acute severe ulcerative colitis (ASUC) are both independently associated with poor outcome. The impact of CDI on the outcome of severe flare of ulcerative colitis is not studied. In the current study, we assess the impact of CDI on the outcome of ASUC.

Methods: Data of ASUC patients were collected from January 2022 to July 2024. Parameters included were demographic profile, disease characteristics, biochemical investigations, and stool C. difficile toxin A/B (CDTA). Patients were categorized into ASUC-CDI and ASUC groups. Primary outcomes were need of rescue therapy, colectomy, and mortality during index admission. Six-month outcomes were flare of disease, colectomy, and mortality.

Results: Of the 117 patients included, 91 (77.8%) patients were in the ASUC group and 26 (22.2%) in the ASUC-CDI group. Baseline parameters were similar between the 2 groups. Overall, 86 (73.5%) patients responded to corticosteroid therapy. Need of rescue therapy (24.2% vs. 33.6%, P=0.287), colectomy (3.3% vs. 11.5%, P=0.093), and mortality (1.1% vs. 3.8%, P=0.345) rates were comparable between the ASUC and ASUC-CDI groups. Six-month colectomy (4.4% vs. 15.4%) and mortality (1.1% vs. 7.7%) rates were numerically higher in the ASUC-CDI group, though statistically nonsignificant.

Conclusion: The immediate and short-term outcome of patients with acute severe ulcerative colitis in the presence of C. difficile infection is determined by the severity of ulcerative colitis flare.

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难辨梭菌感染对严重溃疡性结肠炎结局的影响。

背景：艰难梭菌感染（CDI）和急性严重溃疡性结肠炎（ASUC）都与不良预后独立相关。CDI对溃疡性结肠炎严重发作的影响尚未研究。在本研究中，我们评估了CDI对ASUC预后的影响。方法：收集2022年1月至2024年7月的ASUC患者资料。参数包括人口统计资料、疾病特征、生化调查和粪便艰难梭菌毒素A/B （CDTA）。患者分为ASUC- cdi组和ASUC组。主要结局是需要抢救治疗、结肠切除术和入院时的死亡率。6个月的结果是疾病爆发、结肠切除术和死亡率。结果：纳入的117例患者中，ASUC组91例（77.8%），ASUC- cdi组26例（22.2%）。两组患者的基线参数相似。总体而言，86例（73.5%）患者对皮质类固醇治疗有反应。在ASUC组和ASUC- cdi组中，抢救治疗的需求（24.2%比33.6%，P=0.287）、结肠切除术（3.3%比11.5%，P=0.093）和死亡率（1.1%比3.8%，P=0.345）具有可比性。6个月结肠切除术（4.4% vs. 15.4%）和死亡率（1.1% vs. 7.7%）在ASUC-CDI组中数值较高，但无统计学意义。结论：难辨梭菌感染的急性重度溃疡性结肠炎患者的近期和短期预后取决于溃疡性结肠炎爆发的严重程度。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of clinical gastroenterology 医学-胃肠肝病学

CiteScore

5.60

自引率

3.40%

发文量

339

审稿时长

3-8 weeks

期刊介绍： Journal of Clinical Gastroenterology gathers the world''s latest, most relevant clinical studies and reviews, case reports, and technical expertise in a single source. Regular features include cutting-edge, peer-reviewed articles and clinical reviews that put the latest research and development into the context of your practice. Also included are biographies, focused organ reviews, practice management, and therapeutic recommendations.