[Infection rate and clinical characteristics of toxigenic in children with inflammatory bowel disease].

To explore the infection rate and clinical characteristics of toxigenic in children with inflammatory bowel disease (IBD). From July 2015 to October 2016, the fecal samples and clinical data of 30 IBD children admitted to Department of Gastroenterology, Beijing Children's Hospital, Capital Medical University, as well as the specimens and data of 30 healthy children were collected in the meantime. The toxin gene of was detected and clinical characteristics of children with positive toxin gene were analyzed retrospectively. χ(2) test was used to compare the variables between groups. Among the 30 IBD patients, 15 were in ulcerative colitis (UC) group and 15 in Crohn's disease (CD) group. In the IBD group, 6 (3 in UC and 3 in CD group) had positive result of toxigenic (20%), among whom 5 were toxin A (tcdA) +toxin B (tcdB) -, and 1 was tcdA+tcdB+. In the healthy group, only one had positive result of toxigenic (3%), which was tcdA+tcdB-. Binary toxin gene was negative in both groups. The infection rate of toxigenic in IBD group was significantly higher than that in healthy control group (χ(2)=4.043, 0.044). In UC group, no toxin gene was detected during the remission period (0/1), one case was positive for toxin gene (1/11) during mild active period, and 2 cases were (2/3) during moderately active period. There were significant differences in the infection rate of toxigenic between patients in different active period (χ(2)=4.000, 0.046). The main manifestations of the 6 cases were diarrhea, abdominal pain and bloody stool, and the relapsed case was characterized by sudden aggravation. TcdA was detected in all toxin gene positive samples, and 1 case combined with tcdB had more serious bloody mucopurulent stool. Five cases had colonoscopy, but there was no obvious characteristics of toxigenic colitis such as yellow white plaques or pseudomembranous spot. Three cases had antibiotic exposure history. All 6 cases were sensitive to metronidazole treatment, and stable without relapse during the 3-month follow-up. The infection rate of toxigenic in children with IBD is higher than that in healthy children. The patients with both tcdA and tcdB could have more serious clinical symptoms, although there may not be specific pathological changes of toxigenic colitis. The recognition of toxigenic infection in IBD children should be strengthened in clinical work.