Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins School of Medicine, Brady 320, 600 N. Wolfe Street, Baltimore, MD, 21287, USA,
Dig Dis Sci. 2014 Sep;59(9):2222-7. doi: 10.1007/s10620-014-3169-4. Epub 2014 May 1.
Adults with inflammatory bowel disease (IBD) have a high prevalence of Clostridium difficile infection (CDI). CDI in children with IBD may differ from adults. We aim to compare the prevalence of CDI in hospitalized pediatric and adult IBD patients and patients without IBD.
The rates of CDI per 1,000 IBD and non-IBD hospitalizations between 1993 and 2012 were examined using the Maryland Health Services Cost Review Commission database. Age, sex and calendar year adjusted incidence rate ratios comparing CDI in pediatrics and adults by type of IBD and with patients without IBD were calculated. p values for trend identifying changes in rates over time were calculated.
Among children, the rate of CDI was over 12 times greater in IBD than non-IBD hospitalizations (p < 0.0001) and among adults, the rate of CDI was four times greater in IBD than non-IBD hospitalizations (p < 0.0001). In adults, CDI was significantly higher in ulcerative colitis (UC) than Crohn's disease (60.4 per 1,000 vs. 19.8 per 1,000, p < 0.0001) but in children there was no difference in CDI in UC compared with Crohn's disease (32 per 1,000 vs. 27 per 1,000, p = 0.45). The prevalence of CDI increased in pediatric and adult IBD patients, and patients without IBD, between 1993 and 2012 (p for trend <0.0001).
CDI was more common in adult patients with UC, and no difference was found between CDI and IBD type in pediatrics. There may be different risk factors for CDI during hospitalization between adults and children with IBD.
炎症性肠病（IBD）成人患者中艰难梭菌感染（CDI）的患病率较高。儿童 IBD 患者中的 CDI 可能与成人不同。我们旨在比较住院儿童和成人 IBD 患者以及非 IBD 患者中 CDI 的患病率。
使用马里兰州医疗服务成本审查委员会数据库，检查 1993 年至 2012 年期间每 1000 例 IBD 和非 IBD 住院患者中 CDI 的发生率。通过 IBD 类型和非 IBD 患者比较儿科和成人 CDI，计算年龄、性别和日历年调整后的发病率比。计算用于识别随时间变化的趋势的 p 值。
在儿童中，IBD 住院患者中 CDI 的发生率是无 IBD 住院患者的 12 倍以上（p<0.0001），在成人中，IBD 住院患者中 CDI 的发生率是非 IBD 住院患者的 4 倍以上（p<0.0001）。在成人中，溃疡性结肠炎（UC）中 CDI 的发生率明显高于克罗恩病（60.4 例/1000 与 19.8 例/1000，p<0.0001），但在儿童中 UC 与克罗恩病中 CDI 无差异（32 例/1000 与 27 例/1000，p=0.45）。1993 年至 2012 年期间，儿童和成人 IBD 患者以及非 IBD 患者中 CDI 的患病率均增加（趋势 p 值<0.0001）。
UC 成人患者中 CDI 更为常见，而儿科中 CDI 与 IBD 类型之间无差异。IBD 住院患儿和成人患者中 CDI 的发生可能有不同的危险因素。
