Sangurima Leslie, Malik Maujid Masood, Ganatra Nency, Siby Rosemary, Kumar Sanjay, Khan Sara, Cheriachan Doju, Mohammed Lubna
Internal Medicine, California Institute of Behavioral Neurosciences and Psychology, Fairfield, USA.
Biomedical Sciences, King Faisal University, Hofuf, SAU.
Cureus. 2023 Aug 8;15(8):e43134. doi: 10.7759/cureus.43134. eCollection 2023 Aug.
infection (CDI) is one of the most common diseases associated with medical care, having a more significant impact on patients with inflammatory bowel disease (IBD). The latest studies have proposed a change in management for CDI in IBD patients. This study aims to perform a systematic review that explores the risk factors associated with the infection and the most optimal approach in management. Multiple databases were used for this research, including PubMed, Google Scholar, Science Direct, and Cochrane Library. Studies published in the last five years in the English language were selected based on pre-established criteria. The quality assessment used was the Assessment of Multiple Systematic Review, the Newcastle-Ottawa Scale, and the Scale for the Assessment of Narrative Review Articles. Twelve studies met the inclusion criteria in this systematic review, including literature reviews, a case and control study, and systematic reviews and meta-analyses. Based on the findings in this research, we conclude that the treatment for an initial episode of CDI in IBD patients is the use of antibiotics, vancomycin, or fidaxomicin. For episodes of recurrent CDI (rCDI), fetal microbiota transplantation should be considered. The most common risk factors associated are gut microbiota disturbances, the use of antibiotics, and hospitalization. Due to a wide range of risk factors mentioned in some studies but disregarded in others, further research is needed to determine the most prevalent risk factors.
艰难梭菌感染(CDI)是与医疗保健相关的最常见疾病之一,对炎症性肠病(IBD)患者的影响更大。最新研究提出了IBD患者CDI管理方式的改变。本研究旨在进行一项系统评价,探讨与该感染相关的危险因素以及最优化的管理方法。本研究使用了多个数据库,包括PubMed、谷歌学术、科学Direct和考科蓝图书馆。根据预先设定的标准,选取了过去五年以英文发表的研究。所使用的质量评估方法有多项系统评价评估、纽卡斯尔-渥太华量表以及叙述性综述文章评估量表。十二项研究符合本系统评价的纳入标准,包括文献综述、病例对照研究以及系统评价和荟萃分析。基于本研究的结果,我们得出结论,IBD患者初次CDI发作的治疗方法是使用抗生素、万古霉素或非达霉素。对于复发性CDI(rCDI)发作,应考虑进行粪便微生物群移植。相关的最常见危险因素是肠道微生物群紊乱、使用抗生素和住院治疗。由于一些研究中提到了广泛的危险因素,而另一些研究则未考虑,因此需要进一步研究以确定最普遍的危险因素。