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News

C difficile in IBD is acquired prior to hospitalization

C difficile infections in IBD are confirmed within 48 hours of admission, suggesting most are acquired before hospitalization, reports the latest Clinical Gastroenterology & Hepatology.

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Clostridium difficile-associated disease rates have been increasing.

Dr Joseph Rodemann and colleagues from Missouri determined whether C difficile-associated disease incidence has increased in hospitalized patients with inflammatory bowel disease (IBD).

The team also explored possible differences in the risk for and time to presentation of C difficile-associated disease between IBD and non-IBD patients.

Time from admission to a positive C difficile test for Crohn's was under a day
Clinical Gastroenterology & Hepatology

The research team analyzed hospital admissions from 1998 to 2004 for demographics, length of stay, C difficile infections.

The research team also analyzed time from admission to a positive C difficile test.

The team calculated C difficile-associated disease incidence for non-IBD, IBD, Crohn's-disease, and ulcerative colitis admissions.

The researchers used logistic regression to estimate the risk for C difficile-associated disease.

The team found C difficile-associated disease incidence increased in each group.

The incidence of C difficile was higher in all groups with IBD than non-IBD groups.

During the observation period, C difficile-associated disease rates approximately doubled in Crohn-disease, and tripled in ulcerative colitis.

The researchers observed that length of stay was similar among the groups.

For all years combined, the adjusted odds ratio for C difficile-associated disease in all IBD admissions was 3.

The team noted that the adjusted odds ratio for C difficile-associated disease in Crohn‘s-disease admissions was 2.

The adjusted odds ratio for C difficile-associated disease for ulcerative colitis admissions was 4.

The median times from admission to a positive C difficile test result for non-IBD, and Crohn's disease were 4 days, and less than 1 day, respectively.

The team found that the median time from admission to a positive C difficile test result for ulcerative colitis was half a day.

Dr Rodemann's team commented, “C difficile-associated disease incidence in IBD has increased, and is higher than in the non-IBD population.”

“IBD and ulcerative colitis patients in particular have a higher risk for C difficile-associated disease.”

C difficile infections in IBD are confirmed predominantly within 48 hours of admission, suggesting most were acquired before hospitalization.”

Clin Gastroenterol Hepatol 2007: 5(3): 339-44
28 March 2007

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