Clostridium difficile при воспалительных заболеваниях кишечника
Clostridium difficile при воспалительных заболеваниях кишечника
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Аннотация
Цель – изучить эпидемиологию и факторы риска возникновения клостридиальной инфекции (КДИ), связанной с Clostridium difficile у пациентов с воспалительными заболеваниями кишечника (ВЗК).
Материалы и методы. В ретроспективном исследовании пациентов с ВЗК проанализировано 1179 медицинских карт, из них 764 пациента соответствовали критериям включения. Пациентов разделили на 2 группы на основании наличия предварительного диагноза КДИ. Статистический анализ проводился с помощью χ2 Пирсона и двухвыборочного t-теста.
Результаты. Частота КДИ среди пациентов с ВЗК составила 17,3%, при этом выявлена одинаковая распространенность КДИ у больных болезнью Крона (БК; n=53/40,1%) и язвенным колитом (ЯК; n=79/59,9%). Средний возраст возникновения КДИ у пациентов с ВЗК составил 37,8±12,9 года, при этом 84,8% инфекций были внебольничными и только 4,5% возникли в медицинских учреждениях. У 21,2% пациентов с ВЗК с КДИ в анамнезе были указания на использование антибиотиков, а 24,2% ранее применяли стероиды. Длительная иммуносупрессивная терапия у пациентов с ВЗК оказывает влияние на развитие КДИ: среди пациентов с КДИ 45,5% длительно получали азатиоприн/6-меркаптопурин, у пациентов без ВЗК – 17,7% (p<0,001). Контролировать заболевания с помощью терапии салицилатами могли 18% пациентов с ВЗК с КДИ, в то время как 62% пациентов без КДИ достигали ремиссии заболевания, принимая салицилаты (p<0,05).
Заключение. Распространенность у больных КДИ при ЯК и при БК оказалась сопоставимой (p=0,16). Исследование показывает, что пациенты с ВЗК более чувствительны к развитию КДИ в молодом возрасте, причем, не имея таких традиционных факторов риска, как недавняя госпитализация или прием антибиотиков. У больных ВЗК с КДИ в анамнезе чаще отмечается неэффективность терапии салицилатами, чаще требуется назначение биологической терапии. Пациенты с ВЗК с КДИ имеют более низкое среднее значение альбумина и более высокую активность воспалительного процесса.
Ключевые слова: воспалительные заболевания кишечника, клостридиальная инфекция.
Materials and methods. 1179 medical records were analyzed in a retrospective study of patients with IBD, of which 764 patients met the inclusion criteria. Patients were divided into 2 groups based on the presence of a preliminary diagnosis of CDI. Statistical analysis was carried out using Pearson Chi-square and two-sample t-test.
Results. The incidence of CDI in patients with IBD was 17.3%, with the same prevalence in patients with Crohn's disease (CD) (n=53/40.1%) and ulcerative colitis (UC) (n=79/59.9%). The mean age of occurrence of CDI in patients with IBD was 37.8±12.9, 84.8% of infections were community-acquired and only 4.5% occurred in medical institutions. Only 21.2% of all patients with CDI had a history of antibiotic use, and 24.2% had previously used steroids. Long-term immunosuppressive therapy in patients with IBD has an impact on the development of CDI: among patients with CDI 45.5% long-term received azathioprine/6-mercaptopurine, in patients without IBD – 17.7% (p<0.001). 18% of patients with CDI had control of the disease with salicylate therapy, while 62% of patients without CDI achieved remission by taking salicylates (p<0.05).
Conclusion. The prevalence of CDI in UC and CD is comparable (p=0.16). The study shows that patients with IBD are more sensitive to the development of CDI at a young age, while not having such traditional risk factors as recent hospitalization or antibiotic use. Patients with IBD with CDI in history often noted the ineffectiveness of therapy with salicylates, often require the assignment of biological therapy. IBD patients with CDI have a lower average albumin, and a higher activity of the inflammatory process.
Keywords: inflammatory bowel disease, Clostridium infection.
Материалы и методы. В ретроспективном исследовании пациентов с ВЗК проанализировано 1179 медицинских карт, из них 764 пациента соответствовали критериям включения. Пациентов разделили на 2 группы на основании наличия предварительного диагноза КДИ. Статистический анализ проводился с помощью χ2 Пирсона и двухвыборочного t-теста.
Результаты. Частота КДИ среди пациентов с ВЗК составила 17,3%, при этом выявлена одинаковая распространенность КДИ у больных болезнью Крона (БК; n=53/40,1%) и язвенным колитом (ЯК; n=79/59,9%). Средний возраст возникновения КДИ у пациентов с ВЗК составил 37,8±12,9 года, при этом 84,8% инфекций были внебольничными и только 4,5% возникли в медицинских учреждениях. У 21,2% пациентов с ВЗК с КДИ в анамнезе были указания на использование антибиотиков, а 24,2% ранее применяли стероиды. Длительная иммуносупрессивная терапия у пациентов с ВЗК оказывает влияние на развитие КДИ: среди пациентов с КДИ 45,5% длительно получали азатиоприн/6-меркаптопурин, у пациентов без ВЗК – 17,7% (p<0,001). Контролировать заболевания с помощью терапии салицилатами могли 18% пациентов с ВЗК с КДИ, в то время как 62% пациентов без КДИ достигали ремиссии заболевания, принимая салицилаты (p<0,05).
Заключение. Распространенность у больных КДИ при ЯК и при БК оказалась сопоставимой (p=0,16). Исследование показывает, что пациенты с ВЗК более чувствительны к развитию КДИ в молодом возрасте, причем, не имея таких традиционных факторов риска, как недавняя госпитализация или прием антибиотиков. У больных ВЗК с КДИ в анамнезе чаще отмечается неэффективность терапии салицилатами, чаще требуется назначение биологической терапии. Пациенты с ВЗК с КДИ имеют более низкое среднее значение альбумина и более высокую активность воспалительного процесса.
Ключевые слова: воспалительные заболевания кишечника, клостридиальная инфекция.
________________________________________________
Materials and methods. 1179 medical records were analyzed in a retrospective study of patients with IBD, of which 764 patients met the inclusion criteria. Patients were divided into 2 groups based on the presence of a preliminary diagnosis of CDI. Statistical analysis was carried out using Pearson Chi-square and two-sample t-test.
Results. The incidence of CDI in patients with IBD was 17.3%, with the same prevalence in patients with Crohn's disease (CD) (n=53/40.1%) and ulcerative colitis (UC) (n=79/59.9%). The mean age of occurrence of CDI in patients with IBD was 37.8±12.9, 84.8% of infections were community-acquired and only 4.5% occurred in medical institutions. Only 21.2% of all patients with CDI had a history of antibiotic use, and 24.2% had previously used steroids. Long-term immunosuppressive therapy in patients with IBD has an impact on the development of CDI: among patients with CDI 45.5% long-term received azathioprine/6-mercaptopurine, in patients without IBD – 17.7% (p<0.001). 18% of patients with CDI had control of the disease with salicylate therapy, while 62% of patients without CDI achieved remission by taking salicylates (p<0.05).
Conclusion. The prevalence of CDI in UC and CD is comparable (p=0.16). The study shows that patients with IBD are more sensitive to the development of CDI at a young age, while not having such traditional risk factors as recent hospitalization or antibiotic use. Patients with IBD with CDI in history often noted the ineffectiveness of therapy with salicylates, often require the assignment of biological therapy. IBD patients with CDI have a lower average albumin, and a higher activity of the inflammatory process.
Keywords: inflammatory bowel disease, Clostridium infection.
Список литературы
1. Magill SS, Edwards JR, Bamberg W, et al. Multistate point-prevalence survey of health care associated infections. New Eng J Med. 2014;370:1198-208.
2. Salen P, Stankewicz HA. Colitis, Pseudomembranous. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan–2017 Dec 4.
3. Tariq R, Singh S, Gupta A, Pardi DS, Khanna S. Association of Gastric Acid Suppression With Recurrent Clostridium difficile Infection: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017(Jun1);177(6):784-91. doi: 10.1001/jamainternmed.2017.0212
4. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. New Eng J Med. 2015;372(9):825-34.
5. Miller BA, Chen LF, Sexton DJ, Anderson DJ. Comparison of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infection Control and Hospital Epidemiology. 2011;32(4):387-90.
6. Zimlichman E, Henderson D, Tamir O, et al. Health care associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Int Med. 2013;173(22):2039-46.
7. Bignardi GE. Risk factors for Clostridium difficile infection. J Hosp Inf. 1998;40(1):1-15.
8. Khannaand S, Pardi DS. IBD:poor out comes after Clostridium difficile infection in IBD. Nat Rev Gastroenterol Hepatol. 2012;9(6):307-8.
9. Ananthakrishnan AN, Mc Ginley EL, Binion DG. Excess hospitalisation burden associated with Clostridium difficile in patients with inflammatory bowel disease. Gut. 2008;57(2):205-10.
10. Ananthakrishnan AN, Oxford EC, Nguyen DD, Sauk J, Yajnik V, Xavier RJ. Disclosures Genetic Risk Factors for Clostridium difficile Infection in Ulcerative Colitis. Aliment Pharmacol Ther. 2013;38(5):522-30.
11. Khanna S, Pardi DS. The growing incidence and severity of Clostridium difficile infectionin inpatient and outpatient settings. Exp Rev Gastroenterol Hepatol. 2010;4(4):409-16.
12. Khanna S, Pardi DS, Aronson SL, et al. The epidemiology of community-acquired Clostridium difficile infection: a population-based study. Am J Gastroenterol. 2012;107(1):89-95.
13. Cohen SH, Gerding DN, Johnsonetal S. Clinicalpractice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Health care Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infection Control and Hospital Epidemiology. 2010;31(5):431-55.
14. Nguyen GC, Kaplan GG, Harris NL, Brant SR. A national survey of the prevalence and impact of Clostridium difficile infection among hospitalized inflammatory bowel disease patients. Am J Gastroenterol. 2008;103(6):1443-50.
15. Issa M, Vijayapal A, Graham MB, et al. Impact of Clostridium difficile on inflammatory bowel disease. Clin Gastroenterol Hepatol. 2007;5(3):345-51.
16. Soler P, Nogareda F, Cano R. Rates of Clostridium difficile infection in patients discharged from Spanish hospitals, 1997-2005. Infection Control and Hospital Epidemiology. 2008;29(9):887-9.
17. Burckhardt F, Friedrich A, Beier D, Eckmanns T. Clostridium difficile surveillance trends, Saxony, Germany. Emerg Infect Dis. 2008;14:691-92.
18. Lucado J, Gould C, Elixhauser A. Clostridium difficile infections (CDI) in hospital stays, 2009: statistical brief №124, in Healthcare Cost and Utilization Project (HCUP) Statistical Briefs, Agency for Healthcare Research and Quality (US), Rockville (MD), 2006.
19. Reveles KR, Lee GC, Boyd NK, Frei CR. Therisein Clostridium difficile infection incidence among hospitalized adults in the United States: 2001–2010. Am J Infect Control. 2014;42(10):1028-32.
20. Wilcox MH, Shetty N, Fawley WN, et al. Changing epidemiology of Clostridium difficile infection following the introduction of a national ribotyping-based surveillance scheme in England. Clin Infect Dis. 2012;55(8):1056-63.
21. Wilcox MH, Mooney L, Bendall R, Settle CD, Fawley WN. A case-control study of community-associated Clostridium difficile infection. J Antimicrob Chemother. 2008;62(2):388-96.
22. Kutty PK, Woods CW, Sena AC, et al. Risk factors for and estimated incidence of community-associated Clostridium difficile infection, North Carolina, USA. Emerging Infectious Diseases. 2010;16:197-204.
23. Lambert PJ, Dyck M, Thompson LH, Hammond GW. Population-based surveillance of Clostridium difficile infection in Manitoba, Canada, by using interim surveillance definitions. Infection Control and Hospital Epidemiology. 2009;30(10):945-51.
24. Issa M, Ananthakrishnan AN, Binion DG. Clostridium difficile and inflammatory bowel disease. Inflammat Bowel Diseases. 2008;14(10):1432-42.
25. Das R, Feuerstadt P, Brandt LJ. Glucocorticoids are associated with increased risk of short-term mortality in hospitalized patients with clostridium difficile-associated disease. Am J Gastroenterol. 2010;105(9):2040-9.
26. Khanna S, Tosh PK. A clinician’s primer on the role of the microbiome in human health and disease. Mayo Clinic Proceedings. 2014;89(1):107-14.
27. Matsuoka K, Kanai T. The gut microbiota and inflammatory bowel disease. Seminars in Immunopathology. 2015;37(1):47-55.
28. Schneeweiss S, Korzenik J, Solomon DH, Canning C, Lee J, Bressler B. Infliximab and other immunomodulating drugs in patients with inflammatory bowel disease and the risk of serious bacterial infections. Alimentary Pharmacol Therapeutics. 2009;30(3):253-64.
29. Kariv R, Navaneethan U, Venkatesh PG, Lopez R, Shen B. Impact of Clostridium difficile infection in patients with ulcerative colitis. J Crohn's & Colitis. 2011;5(1):34-40.
30. Engel MA, Neurath MF. New pathophysiological insights and modern treatment of IBD. J Gastroenterol. 2010;45(6):571-83.
31. Князев О.В., Парфенов А.И., Ручкина И.Н., Лазебник Л.Б., Сагынбаева В.Э. Иммунный ответ на биологическую терапию воспалительных заболеваний кишечника. Терапевтический архив. 2013;85(12):55-9 [ Knyazev OV, Parfenov AI, Ruchkina IN, Lazebnik LB, Sagynbaeva VE. Immune response to biological therapy of inflammatory bowel diseases. Ter Arkh. 2013;85(12):55-9 (In Russ.)].
32. William Gillespie, Neil Marya, Julien Fahed, Gregory Leslie, Krunal Patel, David R. Cave. Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study. Gastroenterology Research and Practice Volume. 2017; Article ID 4803262:5. https://doi.org/10.1155/ 2017/4803262.
2. Salen P, Stankewicz HA. Colitis, Pseudomembranous. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan–2017 Dec 4.
3. Tariq R, Singh S, Gupta A, Pardi DS, Khanna S. Association of Gastric Acid Suppression With Recurrent Clostridium difficile Infection: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017(Jun1);177(6):784-91. doi: 10.1001/jamainternmed.2017.0212
4. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. New Eng J Med. 2015;372(9):825-34.
5. Miller BA, Chen LF, Sexton DJ, Anderson DJ. Comparison of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infection Control and Hospital Epidemiology. 2011;32(4):387-90.
6. Zimlichman E, Henderson D, Tamir O, et al. Health care associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Int Med. 2013;173(22):2039-46.
7. Bignardi GE. Risk factors for Clostridium difficile infection. J Hosp Inf. 1998;40(1):1-15.
8. Khannaand S, Pardi DS. IBD:poor out comes after Clostridium difficile infection in IBD. Nat Rev Gastroenterol Hepatol. 2012;9(6):307-8.
9. Ananthakrishnan AN, Mc Ginley EL, Binion DG. Excess hospitalisation burden associated with Clostridium difficile in patients with inflammatory bowel disease. Gut. 2008;57(2):205-10.
10. Ananthakrishnan AN, Oxford EC, Nguyen DD, Sauk J, Yajnik V, Xavier RJ. Disclosures Genetic Risk Factors for Clostridium difficile Infection in Ulcerative Colitis. Aliment Pharmacol Ther. 2013;38(5):522-30.
11. Khanna S, Pardi DS. The growing incidence and severity of Clostridium difficile infectionin inpatient and outpatient settings. Exp Rev Gastroenterol Hepatol. 2010;4(4):409-16.
12. Khanna S, Pardi DS, Aronson SL, et al. The epidemiology of community-acquired Clostridium difficile infection: a population-based study. Am J Gastroenterol. 2012;107(1):89-95.
13. Cohen SH, Gerding DN, Johnsonetal S. Clinicalpractice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Health care Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infection Control and Hospital Epidemiology. 2010;31(5):431-55.
14. Nguyen GC, Kaplan GG, Harris NL, Brant SR. A national survey of the prevalence and impact of Clostridium difficile infection among hospitalized inflammatory bowel disease patients. Am J Gastroenterol. 2008;103(6):1443-50.
15. Issa M, Vijayapal A, Graham MB, et al. Impact of Clostridium difficile on inflammatory bowel disease. Clin Gastroenterol Hepatol. 2007;5(3):345-51.
16. Soler P, Nogareda F, Cano R. Rates of Clostridium difficile infection in patients discharged from Spanish hospitals, 1997-2005. Infection Control and Hospital Epidemiology. 2008;29(9):887-9.
17. Burckhardt F, Friedrich A, Beier D, Eckmanns T. Clostridium difficile surveillance trends, Saxony, Germany. Emerg Infect Dis. 2008;14:691-92.
18. Lucado J, Gould C, Elixhauser A. Clostridium difficile infections (CDI) in hospital stays, 2009: statistical brief №124, in Healthcare Cost and Utilization Project (HCUP) Statistical Briefs, Agency for Healthcare Research and Quality (US), Rockville (MD), 2006.
19. Reveles KR, Lee GC, Boyd NK, Frei CR. Therisein Clostridium difficile infection incidence among hospitalized adults in the United States: 2001–2010. Am J Infect Control. 2014;42(10):1028-32.
20. Wilcox MH, Shetty N, Fawley WN, et al. Changing epidemiology of Clostridium difficile infection following the introduction of a national ribotyping-based surveillance scheme in England. Clin Infect Dis. 2012;55(8):1056-63.
21. Wilcox MH, Mooney L, Bendall R, Settle CD, Fawley WN. A case-control study of community-associated Clostridium difficile infection. J Antimicrob Chemother. 2008;62(2):388-96.
22. Kutty PK, Woods CW, Sena AC, et al. Risk factors for and estimated incidence of community-associated Clostridium difficile infection, North Carolina, USA. Emerging Infectious Diseases. 2010;16:197-204.
23. Lambert PJ, Dyck M, Thompson LH, Hammond GW. Population-based surveillance of Clostridium difficile infection in Manitoba, Canada, by using interim surveillance definitions. Infection Control and Hospital Epidemiology. 2009;30(10):945-51.
24. Issa M, Ananthakrishnan AN, Binion DG. Clostridium difficile and inflammatory bowel disease. Inflammat Bowel Diseases. 2008;14(10):1432-42.
25. Das R, Feuerstadt P, Brandt LJ. Glucocorticoids are associated with increased risk of short-term mortality in hospitalized patients with clostridium difficile-associated disease. Am J Gastroenterol. 2010;105(9):2040-9.
26. Khanna S, Tosh PK. A clinician’s primer on the role of the microbiome in human health and disease. Mayo Clinic Proceedings. 2014;89(1):107-14.
27. Matsuoka K, Kanai T. The gut microbiota and inflammatory bowel disease. Seminars in Immunopathology. 2015;37(1):47-55.
28. Schneeweiss S, Korzenik J, Solomon DH, Canning C, Lee J, Bressler B. Infliximab and other immunomodulating drugs in patients with inflammatory bowel disease and the risk of serious bacterial infections. Alimentary Pharmacol Therapeutics. 2009;30(3):253-64.
29. Kariv R, Navaneethan U, Venkatesh PG, Lopez R, Shen B. Impact of Clostridium difficile infection in patients with ulcerative colitis. J Crohn's & Colitis. 2011;5(1):34-40.
30. Engel MA, Neurath MF. New pathophysiological insights and modern treatment of IBD. J Gastroenterol. 2010;45(6):571-83.
31. [ Knyazev OV, Parfenov AI, Ruchkina IN, Lazebnik LB, Sagynbaeva VE. Immune response to biological therapy of inflammatory bowel diseases. Ter Arkh. 2013;85(12):55-9 (In Russ.)].
32. William Gillespie, Neil Marya, Julien Fahed, Gregory Leslie, Krunal Patel, David R. Cave. Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study. Gastroenterology Research and Practice Volume. 2017; Article ID 4803262:5. https://doi.org/10.1155/ 2017/4803262.
2. Salen P, Stankewicz HA. Colitis, Pseudomembranous. StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2018 Jan–2017 Dec 4.
3. Tariq R, Singh S, Gupta A, Pardi DS, Khanna S. Association of Gastric Acid Suppression With Recurrent Clostridium difficile Infection: A Systematic Review and Meta-analysis. JAMA Intern Med. 2017(Jun1);177(6):784-91. doi: 10.1001/jamainternmed.2017.0212
4. Lessa FC, Mu Y, Bamberg WM, et al. Burden of Clostridium difficile infection in the United States. New Eng J Med. 2015;372(9):825-34.
5. Miller BA, Chen LF, Sexton DJ, Anderson DJ. Comparison of the burdens of hospital-onset, healthcare facility-associated Clostridium difficile infection and of healthcare-associated infection due to methicillin-resistant Staphylococcus aureus in community hospitals. Infection Control and Hospital Epidemiology. 2011;32(4):387-90.
6. Zimlichman E, Henderson D, Tamir O, et al. Health care associated infections: a meta-analysis of costs and financial impact on the US health care system. JAMA Int Med. 2013;173(22):2039-46.
7. Bignardi GE. Risk factors for Clostridium difficile infection. J Hosp Inf. 1998;40(1):1-15.
8. Khannaand S, Pardi DS. IBD:poor out comes after Clostridium difficile infection in IBD. Nat Rev Gastroenterol Hepatol. 2012;9(6):307-8.
9. Ananthakrishnan AN, Mc Ginley EL, Binion DG. Excess hospitalisation burden associated with Clostridium difficile in patients with inflammatory bowel disease. Gut. 2008;57(2):205-10.
10. Ananthakrishnan AN, Oxford EC, Nguyen DD, Sauk J, Yajnik V, Xavier RJ. Disclosures Genetic Risk Factors for Clostridium difficile Infection in Ulcerative Colitis. Aliment Pharmacol Ther. 2013;38(5):522-30.
11. Khanna S, Pardi DS. The growing incidence and severity of Clostridium difficile infectionin inpatient and outpatient settings. Exp Rev Gastroenterol Hepatol. 2010;4(4):409-16.
12. Khanna S, Pardi DS, Aronson SL, et al. The epidemiology of community-acquired Clostridium difficile infection: a population-based study. Am J Gastroenterol. 2012;107(1):89-95.
13. Cohen SH, Gerding DN, Johnsonetal S. Clinicalpractice guidelines for Clostridium difficile infection in adults: 2010 update by the Society for Health care Epidemiology of America (SHEA) and the Infectious Diseases Society of America (IDSA). Infection Control and Hospital Epidemiology. 2010;31(5):431-55.
14. Nguyen GC, Kaplan GG, Harris NL, Brant SR. A national survey of the prevalence and impact of Clostridium difficile infection among hospitalized inflammatory bowel disease patients. Am J Gastroenterol. 2008;103(6):1443-50.
15. Issa M, Vijayapal A, Graham MB, et al. Impact of Clostridium difficile on inflammatory bowel disease. Clin Gastroenterol Hepatol. 2007;5(3):345-51.
16. Soler P, Nogareda F, Cano R. Rates of Clostridium difficile infection in patients discharged from Spanish hospitals, 1997-2005. Infection Control and Hospital Epidemiology. 2008;29(9):887-9.
17. Burckhardt F, Friedrich A, Beier D, Eckmanns T. Clostridium difficile surveillance trends, Saxony, Germany. Emerg Infect Dis. 2008;14:691-92.
18. Lucado J, Gould C, Elixhauser A. Clostridium difficile infections (CDI) in hospital stays, 2009: statistical brief №124, in Healthcare Cost and Utilization Project (HCUP) Statistical Briefs, Agency for Healthcare Research and Quality (US), Rockville (MD), 2006.
19. Reveles KR, Lee GC, Boyd NK, Frei CR. Therisein Clostridium difficile infection incidence among hospitalized adults in the United States: 2001–2010. Am J Infect Control. 2014;42(10):1028-32.
20. Wilcox MH, Shetty N, Fawley WN, et al. Changing epidemiology of Clostridium difficile infection following the introduction of a national ribotyping-based surveillance scheme in England. Clin Infect Dis. 2012;55(8):1056-63.
21. Wilcox MH, Mooney L, Bendall R, Settle CD, Fawley WN. A case-control study of community-associated Clostridium difficile infection. J Antimicrob Chemother. 2008;62(2):388-96.
22. Kutty PK, Woods CW, Sena AC, et al. Risk factors for and estimated incidence of community-associated Clostridium difficile infection, North Carolina, USA. Emerging Infectious Diseases. 2010;16:197-204.
23. Lambert PJ, Dyck M, Thompson LH, Hammond GW. Population-based surveillance of Clostridium difficile infection in Manitoba, Canada, by using interim surveillance definitions. Infection Control and Hospital Epidemiology. 2009;30(10):945-51.
24. Issa M, Ananthakrishnan AN, Binion DG. Clostridium difficile and inflammatory bowel disease. Inflammat Bowel Diseases. 2008;14(10):1432-42.
25. Das R, Feuerstadt P, Brandt LJ. Glucocorticoids are associated with increased risk of short-term mortality in hospitalized patients with clostridium difficile-associated disease. Am J Gastroenterol. 2010;105(9):2040-9.
26. Khanna S, Tosh PK. A clinician’s primer on the role of the microbiome in human health and disease. Mayo Clinic Proceedings. 2014;89(1):107-14.
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26. Khanna S, Tosh PK. A clinician’s primer on the role of the microbiome in human health and disease. Mayo Clinic Proceedings. 2014;89(1):107-14.
27. Matsuoka K, Kanai T. The gut microbiota and inflammatory bowel disease. Seminars in Immunopathology. 2015;37(1):47-55.
28. Schneeweiss S, Korzenik J, Solomon DH, Canning C, Lee J, Bressler B. Infliximab and other immunomodulating drugs in patients with inflammatory bowel disease and the risk of serious bacterial infections. Alimentary Pharmacol Therapeutics. 2009;30(3):253-64.
29. Kariv R, Navaneethan U, Venkatesh PG, Lopez R, Shen B. Impact of Clostridium difficile infection in patients with ulcerative colitis. J Crohn's & Colitis. 2011;5(1):34-40.
30. Engel MA, Neurath MF. New pathophysiological insights and modern treatment of IBD. J Gastroenterol. 2010;45(6):571-83.
31. [ Knyazev OV, Parfenov AI, Ruchkina IN, Lazebnik LB, Sagynbaeva VE. Immune response to biological therapy of inflammatory bowel diseases. Ter Arkh. 2013;85(12):55-9 (In Russ.)].
32. William Gillespie, Neil Marya, Julien Fahed, Gregory Leslie, Krunal Patel, David R. Cave. Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study. Gastroenterology Research and Practice Volume. 2017; Article ID 4803262:5. https://doi.org/10.1155/ 2017/4803262.
Авторы
О.В. Князев, А.В. Каграманова, М.Е. Чернова, И.А. Корнеева, А.И. Парфенов
ГБУЗ «Московский клинический научно-практический центр имени А.С. Логинова» Департамента здравоохранения города Москвы, Москва, Россия
A.S. Loginov Moscow Сlinical Scientific Сenter, Moscow, Russia
ГБУЗ «Московский клинический научно-практический центр имени А.С. Логинова» Департамента здравоохранения города Москвы, Москва, Россия
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A.S. Loginov Moscow Сlinical Scientific Сenter, Moscow, Russia
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