Managing Clostridium difficile in Inflammatory Bowel Disease (IBD)

Current Gastroenterology Reports

Volumn 16, Issue 7, 2014, Pages

  Hashash, Jana G ^a   Binion, David G ^a  

^a UNIVERSITY OF PITTSBURGH SCHOOL OF MEDICINE   (United States)

Author keywords

C. difficile infection; Fecal microbiome transplant; IBD; Inflammatory bowel disease; Metronidazole; Vancomycin

Indexed keywords

CORTICOSTEROID; FIDAXOMICIN; IMMUNOMODULATING AGENT; METRONIDAZOLE; TUMOR NECROSIS FACTOR INHIBITOR; VANCOMYCIN; ANTIINFECTIVE AGENT;

ANTIBIOTIC THERAPY; ARTICLE; BACTERIUM CARRIER; BIOLOGICAL THERAPY; CLOSTRIDIUM DIFFICILE INFECTION; COLON RESECTION; CROHN DISEASE; DISEASE EXACERBATION; ENZYME LINKED IMMUNOSORBENT ASSAY; FECAL MICROBIOME TRANSPLANTATION; GENE LOCUS; GENETIC MARKER; GENETIC RISK; HOSPITALIZATION; HUMAN; ILEOANAL ANASTOMOSIS; INFLAMMATORY BOWEL DISEASE; NONHUMAN; POLYMERASE CHAIN REACTION; RECURRENT INFECTION; ULCERATIVE COLITIS; COMPLICATION; ENTEROCOLITIS, PSEUDOMEMBRANOUS; FECES; INFLAMMATORY BOWEL DISEASES; MICROBIOLOGY; OPPORTUNISTIC INFECTIONS; PEPTOCLOSTRIDIUM DIFFICILE; TISSUE TRANSPLANTATION;

ANTI-BACTERIAL AGENTS; CLOSTRIDIUM DIFFICILE; ENTEROCOLITIS, PSEUDOMEMBRANOUS; FECES; HUMANS; INFLAMMATORY BOWEL DISEASES; OPPORTUNISTIC INFECTIONS; TISSUE TRANSPLANTATION; VANCOMYCIN;

EID: 84901373449     PISSN: 15228037     EISSN: 1534312X     Source Type: Journal    
DOI: 10.1007/s11894-014-0393-1     Document Type: Article

References (28)

1. Kelly CP, LaMont JT. Clostridium difficile - more difficult than ever. N Engl J Med. 2008;359(18):1932-40. Erratum in: N Engl J Med. 2010 Oct 14;363(16):1585.
2. Rodemann JF, Dubberke ER, Reske KA, da Seo H, Stone CD. Incidence of Clostridium difficile infection in inflammatory bowel disease. Clin Gastroenterol Hepatol. 2007;5(3):339-44. (Pubitemid 46401530)
3. Issa M, Vijayapal A, Graham MB, Beaulieu DB, Otterson MF, Lundeen S, et al. Impact of Clostridium difficile on inflammatory bowel disease. Clin Gastroenterol Hepatol. 2007;5(3):345-51. (Pubitemid 46401531)
4. Ananthakrishnan AN, McGinley EL, Binion DG. Excess hospitalisation burden associated with Clostridium difficile in patients with inflammatory bowel disease. Gut. 2008;57(2):205-10. (Pubitemid 351158048)
5. Burke KE, Lamont JT. Clostridium difficile inection: a worldwide disease. Gut Liver. 2014;8(1):1-6.
6. Jen MH, Saxena S, Bottle A, Aylin P, Pollok RC. Increased health burden associated with Clostridium difficile diarrhoea in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2011;33(12):1322-31.
7. • Murthy SK, Steinhart AH, Tinmouth J, Austin PC, Daneman N, Nguyen GC. Impact of Clostridium difficile colitis on 5-year health outcomes in patients with ulcerative colitis. Aliment Pharmacol Ther. 2012;36(11-12):1032-9. Approximately 9% of hospitalized ulcerative colitis patients have C. difficile infection in this study from Ontario, Canada.
8. Masclee GM, Penders J, Jonkers DM, Wolffs PF, Pierik MJ. Is Clostridium difficile associated with relapse of inflammatory bowel disease? Results from a retrospective and prospective cohort study in the Netherlands. Inflamm Bowel Dis. 2013;19(10):2125 -31.
9. Hourigan SK, Chirumamilla SR, Ross T, Golub JE, Rabizadeh S, Saeed SA, et al. Clostridium difficile carriage and serum antitoxin responses in children with inflammatory bowel disease. Inflamm Bowel Dis. 2013;19(13):2744-52.
10. • Mir SA, Kellermayer R. Clostridium difficile infection in newly diagnosed pediatric inflammatory bowel disease in the midsouthern United States. J Pediatr Gastroenterol Nutr. 2013;57(4):487-8. Approximately 8% of newly diagnosed pediatric IBD patients have C. difficile infection, which supports the practice of testing of all newly diagnosed IBD patients.
11. Dave M, Purohit T, Razonable R, Loftus Jr EV. Opportunistic infections due to inflammatory bowel disease therapy. Inflamm Bowel Dis. 2014;20(1):196-212.
12. • Schneeweiss S, Korzenik J, Solomon DH, Canning C, Lee J, Bressler B. Infliximab and other immunomodulating drugs in patients with inflammatory bowel disease and the risk of serious bacterial infections. Aliment Pharmacol Ther. 2009;30(3):253-64. Corticosteroid exposure tripled risk of IBD patients developing C. difficile infection in this study from British Columbia, Canada. Anti-TNF agents were not associated with developoing C. difficile in IBD.
13. Ananthakrishnan AN, McGinley EL. Infection-related hospitalizations are associated with increased mortality in patients with inflammatory bowel diseases. J Crohn's Colitis. 2013;7(2):107-12.
14. Li Y, Qian J, Queener E, Shen B. Risk factors and outcome of PCR-detected Clostridium difficile infection in ileal pouch patients. Inflamm Bowel Dis. 2013;19(2):397-403.
15. Jostins L, Ripke S, Weersma RK, Duerr RH, McGovern DP, Hui KY, et al. Host-microbe interactions have shaped the genetic architecture of inflammatory bowel disease. Nature. 2012;491(7422):119-24.
16. • Ananthakrishnan AN, Oxford EC, Nguyen DD, Sauk J, Yajnik V, Xavier RJ. Genetic risk factors for Clostridium difficile infection in ulcerative colitis. Aliment Pharmacol Ther. 2013;38(5):522-30. Female gender, pancolitis, and anti-TNF therapy were protective against developing C. difficile infection in this analysis of a small number of ulcerative colitis patients. Increasing number of IBD risk alleles were associated with increased risk of developing C. difficile infection in ulcerative colitis.
17. Deshpande A, Pasupuleti V, Patel P, Pant C, Pagadala M, Hall G, et al. Repeat stool testing for Clostridium difficile using enzyme immunoassay in patients with inflammatory bowel disease increases diagnostic yield. Curr Med Res Opin. 2012;28(9):1553-60.
18. Wang Y, Atreja A, Wu X, Lashner BA, Brzezinski A, Shen B. Similar outcomes of IBD in patients with Clostridium difficile infection detected by ELISA or PCR assay. Dig Dis Sci. 2013;58(8):2308-13.
19. • Sunkesula VC, Kundrapu S, Muganda C, Sethi AK, Donskey CJ. Does empirical Clostridium difficile infection (CDI) therapy result in false-negative CDI diagnostic test results? Clin Infect Dis. 2013;57(4):494-500. Analysis of the performance characteristics of stool PCR testing for C. difficile following initiation of antibiotic therapy against the infection in patients with documented disease. PCR tests turned negative at a rapid rate, with 50% of patients testing negative 3 days into therapy and essentially all patients becoming negative 5 days into treatment. This study demonstrates no role for repeat stool testing as the PCR assay will turn negative prior to completing a therapeutic course of antibiotic therapy for C. difficile infection. It also highlights the importance of completing an empiric course of therapy once initiated, as testing is no longer accurate 3-5 days into treatment.
20. Surawicz CM, Brandt LJ, Binion DG, Ananthakrishnan AN, Curry SR, Gilligan PH, et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. Am J Gastroenterol. 2013;108(4):478-98. quiz 499. Review.
21. • Ananthakrishnan AN, Guzman-Perez R, Gainer V, Cai T, Churchill S, Kohane I, et al. Predictors of severe outcomes associated with Clostridium difficile infection in patients with inflammatory bowel disease. Aliment Pharmacol Ther. 2012;35(7):789-95. Observational clinical trial demonstrating clinical factors which correlate with poor outcome in IBD patients suffering from C. difficile infection.
22. Libot A, Issa M, Zadvornova Y, Stein DJ, Venu N, Perera LP, et al. Initial vancomycin monotherapy is associated with higher rates of subsequent Clostridium difficile infection in inflammatory bowel disease population. Gastroenterology. 2011;140:S-159. abstract #992.
23. • Louie TJ, Miller MA, Mullane KM, Weiss K, Lentnek A, Golan Y, et al. Fidaxomicin versus vancomycin for Clostridium difficile infection. N Engl J Med. 2011;364(5):422-31. Pivotal trial demonstrating safety and efficacy of fidaxomicin in the treatment of initial C. difficile infection and potential superiority with reduction in short term recurrence. IBD patients were excluded from this trial.
24. • van Nood E, Vrieze A, Nieuwdorp M, et al. Duodenal infusion of donor feces for recurrent Clostridium difficile. N Engl J Med. 2013;368:407-15. Pivotal trial establishing the efficacy and superiority of FMT in the treatment of recurrent C. difficile infection.
25. Anderson JL, Edney RJ, Whelan K. Systematic review: Faecal microbiota transplantation in the management of inflammatory bowel disease. Aliment Pharmacol Ther. 2012;36(6):503-16.
26. • De Leon LM, Watson JB, Kelly CR. Transient flare of ulcerative colitis after fecal microbiota transplantation for recurrent Clostridium difficile infection. Clin Gastroenterol Hepatol. 2013;11(8):1036-8. First publication demonstrating problems of FMT for treatment of recurrent C difficile infection in IBD.
27. Vermeire S, Joossens M, Verbeke K, et al. Pilot study on the safety and effi cacy of faecal microbiota transplantation in refractory Crohn's disease. Gastroenterology. 2012;142:S360.
28. Angelberger S, Reinisch W, Makristathis A, Lichtenberger C, Dejaco C, Papay P, et al. Temporal bacterial community dynamics vary among ulcerative colitis patients after fecal microbiota transplantation. Am J Gastroenterol. 2013;108(10):1620-30.