Clinical Study On C. Difficile Infection And Its Susceptibility Factors In Patients With Inflammatory Bowel Disease

Objective:To explore whether it was necessary to detect C.difficile in IBD patients in daily diagnosis and treatment by detecting the infection rate of C.difficile in patients with inflammatory bowel disease(IBD)in Single center and analyzing the related risk factors.Methods:We choose 36 patients with IBD as a research group between the October in 2016 to the June in 2018,including 28 ulcerative colitis(UC)patients and 8 crohn’s disease(CD)patients.At the same time,we choose 36 healthy people introduced from the physical examination center as the control group.The diagnosis of all IBD patients was based on the Consensus Opinions on the Diagnosis and Treatment of Inflammatory Bowel Diseases formulated by the Chinese Medical Association Digestive Branch in Guangzhou in 2012.The infection results of C.difficile were detected by polymerase chain reaction(PCR)and enzyme-linked immunosorbent assay(ELISA),and the C.difficile infection rate and its correlation were analyzed in different clinical characteristics of the study group.Results:C.difficile infection was found in 6 of the 36 IBD patients,with an infection rate of 16.7%(6/36),including 6 cases of ulcerative colitis(6/28,21.4%),0 cases of Crohn’s disease,36 cases C.difficile infection did not occur in the healthy control group,the infection rate was 0%.It was found that the infection rate of C.difficile in IBD patients was higher than that in healthy people(16.7%vs 0%),there was statistical difference between the two groups(χ~2=4.545,P=0.033).The rate of C.difficile infection in patients with proton pump inhibitors(PPI)was higher in the IBD group than in those without PPI(66.7%vs 33.3%),and there was statistical difference between the two groups(P=0.003).The infection rate of hormone C.difficile was higher than that of 5-aminosalicylic acid(5-ASA)(66.7%vs 6.9%),and there was statistical difference between the two groups(P=0.004).In addition,C.difficile infection rate was significantly higher in patients with UC who were treated with hormone therapy than in 5-ASA(66.7%vs 9.1%),there was statistical difference between the two groups(P=0.010),but C.difficile infection occurred in UC patients.It was not related to clinical type,lesion extent and severity(P>0.05).Conclusion:In the Center,the patients with IBD were easier to be found the C.difficile infection than healthy people.The hormone therapy and PPI before treatment were the potential influencing factors on the C.difficile infection status of the patient with IBD.The use of hormones may increase the probability of the C.difficile infection in patients with UC.