Analysis Of Clinical Characteristics And Risk Factorts Of Clostridium Difficile Infection In 116 Inflammatory Bowel Disease Patients

ObjectiveThe number of Closridium dfficile infection(CDI)patients combined with Inflammatory bowel disease(IBD)is rising yearly,In this study,we collected and analyzed the clinical data of 116 IBD patients in our hospital,and investigated the related risk factors of CDI in IBD patients.MethodsIn this study,116 inflammatory bowel disease patients admitted in the Guangdong Sencond Provincial General Hospital from Jnanury 2018 to December 2020 were collected by strict inclusion and exclusion criteria,and75 Ulcerativ colitis(UC)patients and 41 Crohn’s disease(CD)patients were included.All patients underwent electronic colonoscope and C-difficile detection,and were divided into CDI positive group and CDI negative group according to the results of C-difficile detection.85 healthy volunteers without organic lesions were confirmed by colonoscopy in our hospital during the same period as the control group.The patient’s medical history was inquired in detail,and demographic data(such as age,sex,body mass index and smoking history),clinical symptoms(such as fever,abdominal pain,diarrhea),medical use before admission were collected(antibiotics,proton pump inhibitor,aminosalicylic acid,glucocorticoids,immunomodulators,biological agents),laboratory data(such as leukocyte count,neutrophil count,C-reactive protein,albumin),endoscopic manifestations(including mscosal lesions,involvement location and range).These demograhic information,clinical data,laboratory results and medication were compared between the two groups to analyze the clinical characteristics and related risk factors of IBD patients with CDI.Results1.Comparison between IBD group and the control group: there was no significant difference in age and gender between the two groups(P>0.05),The incidence of CDI in the IBD group(17.2%)was higher than that in the control group(1.1%),and the difference was significant(P<0.05).2.Comparison of the rate of CDI between the UC group and the CD group: the infection rate of CDI in the UC group(20.0%)was higher than that in the CD group(12.2%),but the difference was not statistically significant(P>0.05).3.Comparison of general clinical data and CDI in IBD patients: the smoking rate of patients in the C-difficile positive group was higher than that the C-difficile negative group(P<0.05).4.Comparison of different clinical types and CDI in IBD patients: the CDI of patients with active IBD was higher than that of patients with remission IBD(P<0.05).5.Comparison of medication use and CDI in patients with IBD: use of glucocorticoids and immunomodulaters in the Clostridium difficile positive group was higher than those in the Clostridium difficile negative group(P<0.05).6.Logistic regression analysis of Clostridium difficile infection in patients with IBD: the smoking and glucocorticoids use were risk factors for clostridium difficile infection,the risk of CDI in smoking patients was higher than that in non-smoking patients(OR=5.03,95% CI:1.66-15.05,P<0.05),the risk of CDI in glucocorticoids users was higher than that Non-glucocorticoids users(OR=7.84,95% CI:2.32-26.53,P<0.05).Conclusion1.The patients with inflammatory bowel disease had a higher infection rate of C-difficile compared with the healthy control group.2.Smoking and glucocorticoids use are independent risk factors for C-difficile infection in patients with inflammatory bowel disease.