Discussion Clostridium Difficile Infection In Patients With Inflammatory Bowel Disease And Its Relationship With Clinical Features

Object: To figure out inflammatory bowel disease Clostridium difficile infection status, and analyse Clostridium difficile infection relations with ulcerative colitis clinical features.Methods: Collecting 30 cases of inflammatory bowel disease group with inflammatory bowel disease(IBD group), 25 patients with ulcerative colitis(UC), 5patients with Crohn’s disease(CD). 30 healthy volunteers as a control group. There is no history of antibiotics application during the past 2-4 weeks. Collecting their stool specimens and clinical data respectively. All diagnosis of inflammatory bowel disease,are based on "Chinese diagnosis and treatment of inflammatory bowel disease standardized Consensus". By enzyme-linked immunosorbent assay(Enzyme-1inked immunosorbent assay, ELISA) method, for all the set of objects stool specimens for Clostridium difficile toxin A and toxin B testing. Comparison of inflammatory bowel disease patients and healthy volunteers stool Clostridium difficile infection, and ulcerative colitis patients with relapsing forms of early onset, activity and remission,different lesions and different activity levels of Clostridium difficile stool specimens infection rates were compared.Results:1. General InformationInflammatory bowel disease group(ulcerative colitis and Crohn’s disease group,group), 30 cases of patients, 19 males and 11 females, aged 27 to 77 years old, the average age was 51.43 ± 13.04 years. Ulcerative colitis group of 25 patients, 17 males and 8 females, aged 32 to 77 years, the average age was 52.48 ± 12.97 years. Patientswith Crohn’s disease group 5 cases, 2 males and 3 females, aged 27 to 59 years, the average age was 50.20 ± 13.44 years. The healthy control group of 30 patients, 17 males and 13 females, aged 40 to 76 years, the average age was 55.50 ± 8.41 years. 3 cases of early onset ulcerative colitis, recurrent type in 22 cases; 23 cases of active(mild in 6cases, 7 cases of moderate and severe 10 cases), 2 cases of remission; 4 cases were lesions in the scope of the rectum(E1), left half colon(E2) 11 cases, splenic flexure nearly(E3) 10 cases. Inflammatory bowel disease group and healthy controls for age,sex differences had not statistical difference(P values were 0.157,0.598).2. Clostridium difficile infection(1) IBD group compared with the healthy control group Clostridium difficile infection:In 30 cases of inflammatory bowel disease, 8 cases of patients with Clostridium difficile toxin-positive stool samples, including 2 cases of Clostridium difficile toxin A(-), toxin B(+), Clostridium difficile infection rate was 26.7%. In 30 cases of healthy controls, 1 case of Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 3.33%. Inflammatory bowel disease group stool specimens of Clostridium difficile infection rate is significantly higher than healthy control group,the difference was statistically significant(P <0.05).(2) UC group, CD group compared with healthy control group Clostridium difficile infection:25 cases of ulcerative colitis patients, 7 cases of patients Clostridium difficile toxin-positive stool samples, including 2 cases of Clostridium difficile toxin A(-), toxin B(+), Clostridium difficile infection rate was 28.0%.In 5 cases of Crohn’s disease, 1cases of patients Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 20.0%.In 30 healthy control group, 1 case of Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 3.33%.Ulcerative colitis group stool specimens Clostridium difficile infection rate higher than that of healthy controls, the difference was statistically significant(P <0.05), ulcerative colitis and Crohn’s disease group stool samples difficult Clostridium infection rate was no significant difference(P value 1.000).3.Relationship Clostridium difficile infection in patients with ulcerative colitis clinical features(1) UC different clinical types of Clostridium difficile infection:25 cases of ulcerative colitis patients, 3 cases of early onset, stool samples were not detected positive Clostridium difficile toxin, Clostridium difficile infection rate was 0%,22 cases of relapsing, 7 cases of patients Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 31.8%, in patients with relapsing forms of Clostridium difficile infection rate higher than patients with early onset.(2) UC degree of disease activity, and the different activities of Clostridium difficile infection:25 cases of ulcerative colitis patients, 23 patients in disease activity, 7 case of patients Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 30.4%, 2 patients in disease remission, stool specimens were not detected positive Clostridium difficile toxin, Clostridium difficile infection rate was 0%,the patients with disease activity stool samples Clostridium difficile infection rate was higher than patients with disease remission. Ulcerative colitis patients with mild activity of 6 cases, 1 case of patients Clostridium difficile toxin-positive stool samples,Clostridium difficile infection rate was 16.7%, moderate for 7 cases of patients, 2 cases of patients Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 28.6%, severe 10 cases of patients, 4 cases of patients Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 40.0%, the patients with severe activity stool specimens Clostridium difficile infection rate higher than that of patients with mild and moderate activity.(3)UC different lesions scope Clostridium difficile infection:25 cases of ulcerative colitis patients, 4 case of patients for E1 group, stool specimens were not detected positive Clostridium difficile toxin, Clostridium difficile infection rate was 0%, 11 patients for E2 group, 3 cases of patients Clostridium difficile toxin-positive stool samples, Clostridium difficile infection rate was 27.3%, 10 patients for E3 group, 4 cases of patients Clostridium difficile toxin-positive stool samples,Clostridium difficile infection rate was 40.0%, E3 group stool specimens Clostridium difficile infection rate higher than that of E1 and E2 group.Conclusion:1.Patients with inflammatory bowel disease usually complicate with certain degres of clostridium difficile infection.2.Clostridium difficile infection in patients with ulcerative colitis may coincide with disease activity and scope of lesions.