炎症性肠病患儿无症状艰难梭菌定植的患病率及后遗症
Prevalence and sequelae of asymptomatic Clostridioides difficile colonization in children with inflammatory bowel disease.
作者信息
Reasoner Seth A, Zhang Lisa S, Bernard Rachel, Edwards Kathryn M, Nicholson Maribeth R
机构信息
Division of Molecular Pathogenesis, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, Tennessee, USA.
Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Monroe Carell Junior Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.
出版信息
J Pediatr Gastroenterol Nutr. 2025 Mar;80(3):446-449. doi: 10.1002/jpn3.12439. Epub 2024 Dec 20.
Colonization by Clostridioides difficile is common in children with inflammatory bowel disease (IBD) and complicates both the management of IBD and the diagnosis of C. difficile infection (CDI). There is a paucity of data on rates, risk factors, and outcomes associated with asymptomatic C. difficile colonization in children with IBD. We enrolled and prospectively followed 87 children with IBD without acute gastrointestinal symptoms. Twelve patients (13.8%) tested positive for C. difficile and were considered to have asymptomatic colonization. Elevated white blood cell count was associated with C. difficile colonization based on univariate regression. Three of the 12 (25%) C. difficile colonized patients were diagnosed with CDI in the 90 days following screening for C. difficile, versus 0 of the 75 who tested negative for C. difficile (p = 0.002). This data set the stage for further longitudinal tracking of children with IBD for C. difficile colonization and associated outcomes.
艰难梭菌在炎症性肠病（IBD）患儿中定植很常见，这会使IBD的管理和艰难梭菌感染（CDI）的诊断变得复杂。关于IBD患儿无症状艰难梭菌定植的发生率、危险因素和结局的数据很少。我们招募了87名无急性胃肠道症状的IBD患儿并进行前瞻性随访。12名患者（13.8%）艰难梭菌检测呈阳性，被认为有无症状定植。基于单变量回归分析，白细胞计数升高与艰难梭菌定植相关。在艰难梭菌筛查后的90天内，12名艰难梭菌定植患者中有3名（25%）被诊断为CDI，而75名艰难梭菌检测阴性的患者中无一人被诊断为CDI（p = 0.002）。该数据集为进一步纵向追踪IBD患儿的艰难梭菌定植及相关结局奠定了基础。
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