Intestinal Research

Original Articles

IBD

The impact of corticosteroid use on inpatients with inflammatory bowel disease and positive polymerase chain reaction for Clostridium difficile: Huei-Wen Lim, Isaiah P. Schuster, Ramona Rajapakse, Farah Monzur, Sundas Khan, Keith Sultan; Intest Res 2019;17(2):244-252. Published online February 12, 2019; DOI: https://doi.org/10.5217/ir.2018.00101

Background/Aims
Optimal management of inflammatory bowel disease (IBD) with concomitant Clostridium difficile infection (CDI) is controversial, especially when CDI diagnosis is made by polymerase chain reaction (PCR) testing, which may reflect colonization without infection.
Methods
We performed a multicenter review of all inpatients with IBD and PCR diagnosed CDI. Outcomes included length of stay, 30- and 90-day readmission, colectomy during admission and within 3 months, intensive care unit (ICU) admission, CDI relapse and death for patients who received corticosteroid (CS) after CDI diagnosis versus those that did not. Propensity-adjusted regression analysis of outcomes based on CS usage was performed.
Results
We identified 177 IBD patients with CDI, 112 ulcerative colitis and 65 Crohn’s disease. For IBD overall, CS after CDI diagnosis was associated with prolonged hospitalization (5.5 days: 95% confidence interval [CI], 1.5–9.6 days; P=0.008), higher colectomy rate within 3 months (odds ratio [OR], 5.5; 95% CI, 1.1–28.2; P=0.042) and more frequent ICU admissions (OR, 7.8; 95% CI, 1.5–41.6; P=0.017) versus no CS. CS use post-CDI diagnosis in UC patients was associated with prolonged hospitalization (6.2 days: 95% CI, 0.4– 12.0 days; P=0.036) and more frequent ICU admissions (OR, 7.4; 95% CI, 1.1–48.7; P=0.036).
Conclusions
CS use among IBD inpatients with CDI diagnosed by PCR is associated with poorer outcomes and would seem to reinforce the importance of C. difficile toxin assay to help distinguish colonization from infection. This adverse effect appears more prominent among those with UC.

Citations

Citations to this article as recorded by

Clostridioides difficile infection in inflammatory bowel disease: a clinical review
Mengjun Tang, Chunhua Wang, Ying Xia, Jian Tang, Jiao Wang, Liang Shen
Expert Review of Anti-infective Therapy.2024; 22(5): 297. CrossRef
The Current Knowledge on Clostridioides difficile Infection in Patients with Inflammatory Bowel Diseases
Alina Boeriu, Adina Roman, Crina Fofiu, Daniela Dobru
Pathogens.2022; 11(7): 819. CrossRef
Korean Association for the Study of Intestinal Diseases guidance for clinical practice of adult inflammatory bowel disease during the coronavirus disease 2019 pandemic: expert consensus statements
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
Intestinal Research.2022; 20(4): 431. CrossRef
KASID Guidance for Clinical Practice Management of Adult Inflammatory Bowel Disease during the COVID-19 Pandemic: Expert Consensus Statement
Yong Eun Park, Yoo Jin Lee, Ji Young Chang, Hyun Joo Song, Duk Hwan Kim, Young Joo Yang, Byung Chang Kim, Jae Gon Lee, Hee Chan Yang, Miyoung Choi, Seong-Eun Kim, Seung-Jae Myung
The Korean Journal of Gastroenterology.2021; 78(2): 105. CrossRef

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IBD

Is Clostridium difficile infection a real threat in patients with ulcerative colitis? A prospective, multicenter study in Korea: Dae Bum Kim, Kang-Moon Lee, Sang Hyoung Park, You Sun Kim, Eun Soo Kim, Jun Lee, Sung-Ae Jung, Geom Seog Seo, Ji Min Lee; Intest Res 2018;16(2):267-272. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.267

Abstract PDF PubReader ePub

Background/Aims

Clostridium difficile infection (CDI) has been reported to be a cause of flare-ups in patients with ulcerative colitis (UC). We evaluated the prevalence and clinical outcomes of CDI in patients with UC hospitalized for flare-ups.

Methods

This was a prospective, multicenter study including 7 academic teaching hospitals in Korea. All consecutive patients with UC admitted for disease flare-up were enrolled. We detected the presence of CDI by using enzyme immunoassay, real-time polymerase chain reaction (RT-PCR) for toxin genes, and sigmoidoscopy.

Results

Eighty-one consecutive patients with UC were enrolled from January 2014 to December 2015. Among 81 patients, 8 (9.9%) were diagnosed with CDI. Most of the cases were identified by RT-PCR. Enzyme immunoassay was positive in 3 of 8 patients, and only 1 had typical endoscopic findings of pseudomembranous colitis. There were no differences in demographic data, length of hospital stay, or colectomy rate between patients with and without CDI.

Conclusions

CDI was not a rare cause of flare-up in patients with UC in Korea. However, CDI did not appear to affect the course of UC flare-up in Korean patients. RT-PCR was sensitive in detecting CDI and can be considered a diagnostic tool in patients with UC flare-up.

Citations

Citations to this article as recorded by

Association of Clostridium difficile infection with clinical outcomes of patients with inflammatory bowel disease: A meta-analysis
Hai-Xin Qi, Qi Wang, Gui-Qun Zhou
World Journal of Gastrointestinal Surgery.2025;[Epub] CrossRef
Low prevalence of Clostridioides difficile infection in acute severe ulcerative colitis: A retrospective cohort study from northern India
Sandeep Mundhra, David Thomas, Saransh Jain, Pabitra Sahu, Sudheer Vuyyuru, Peeyush Kumar, Bhaskar Kante, Rajesh Panwar, Peush Sahni, Rama Chaudhry, Prasenjit Das, Govind Makharia, Saurabh Kedia, Vineet Ahuja
Indian Journal of Gastroenterology.2023; 42(3): 411. CrossRef
The Prevalence and Risk Factors of Clostridioides difficile Infection in Inflammatory Bowel Disease: 10-Year South Korean Experience Based on the National Database
Eun Mi Song, Arum Choi, Sukil Kim, Sung Hoon Jung
Journal of Korean Medical Science.2023;[Epub] CrossRef
Clostridioides Infection in Patients with Inflammatory Bowel Disease
Mi Rae Lee, Eun Soo Kim
The Korean Journal of Gastroenterology.2022; 80(2): 66. CrossRef
Clostridium difficile in ulcerative colitis; a retrospective study
O. V. Knyazev, A. V. Kagramanova, M. E. Chernova, I. A. Koroleva, A. I. Parfenov
Almanac of Clinical Medicine.2018; 46(5): 474. CrossRef

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Microbiota

Characterization of the fecal microbiota differs between age groups in Koreans: Sun-Young Kook, Yunjeong Kim, Ben Kang, Yon Ho Choe, Young-Ho Kim, Seokjin Kim; Intest Res 2018;16(2):246-254. Published online April 30, 2018; DOI: https://doi.org/10.5217/ir.2018.16.2.246

Abstract PDF Supplementary Material PubReader ePub

Background/Aims

Tens of trillions of microorganisms constitute the gut microbiota of the human body. The microbiota plays a critical role in maintaining host immunity and metabolism. Analyses of the gut microbial composition in Korea are limited to a few studies consisting of small sample sizes. To investigate the gut microbial community in a large sample of healthy Koreans, we analyzed the 16S ribosomal RNA of 4 representative bacterial genera Lactobacillus, Bifidobacterium, Bacteroides, and Clostridium.

Methods

A total of 378 DNA samples extracted from 164 infants and 214 adults were analyzed using quantitative real-time polymerase chain reaction.

Results

Analysis of 16S ribosomal RNA of 4 representative bacterial genera Lactobacillus, Bifidobacterium, Bacteroides, and Clostridium showed that the gut microbiota in infants had higher relative abundances of Bifidobacterium and Lactobacillus than that in adults, which was dominated by Bacteroides and Clostridium.

Conclusions

To the best of our knowledge, this was the first study evaluating the distinct characteristics of the microbial community of Korean infants and adults. The differences between the 2 populations suggest that external factors such as age, diet, and the environment are important contributing factors to the change in gut microbial composition during development.

Citations

Citations to this article as recorded by

Effects of Administration of Prebiotics Alone or in Combination with Probiotics on In Vitro Fermentation Kinetics, Malodor Compound Emission and Microbial Community Structure in Swine
Maro Lee, Yeonjae Choi, Joel Bayo, Andrew Wange Bugenyi, Yangseon Kim, Jaeyoung Heo
Fermentation.2023; 9(8): 716. CrossRef
Statistical Optimization of Culture Conditions for Lactobacillus Strains using Response Surface Methodology
Young Min Hwang, Hee-Seok Lee
Journal of Food Hygiene and Safety.2023; 38(5): 338. CrossRef
The correlation of the fecal microbiome with the biochemical profile during menopause: a Brazilian cohort study
Thayane Christine Alves da Silva, Jennefer Aparecida dos Santos Gonçalves, Laura Alves Cota e Souza, Angélica Alves Lima, R. Guerra-Sá
BMC Women's Health.2022;[Epub] CrossRef
The Effect of Kefir Supplementation on Improving Human Endurance Exercise Performance and Antifatigue
Mon-Chien Lee, Wei-Lun Jhang, Chia-Chia Lee, Nai-Wen Kan, Yi-Ju Hsu, Chin-Shan Ho, Chun-Hao Chang, Yi-Chen Cheng, Jin-Seng Lin, Chi-Chang Huang
Metabolites.2021; 11(3): 136. CrossRef
Space, time and captivity: quantifying the factors influencing the fecal microbiome of an alpine ungulate
Sarah E Haworth, Kevin S White, Steeve D Côté, Aaron B A Shafer
FEMS Microbiology Ecology.2019;[Epub] CrossRef
Isolation and characterization of five novel probiotic strains from Korean infant and children faeces
Sun-Young Kook, Eui-Chun Chung, Yaelim Lee, Dong Wan Lee, Seokjin Kim, Sudarshan Kumar
PLOS ONE.2019; 14(10): e0223913. CrossRef
Characteristics of Faecal Microbiota in Korean Patients withClostridioides difficile-associated Diarrhea
Yong Duk Jeon, Hea Won Ann, Woon Ji Lee, Jun Hyoung Kim, Hye Seong, Jung Ho Kim, Jin Young Ahn, Su Jin Jeong, Nam Su Ku, Joon Sup Yeom, Dongeun Yong, Kyungwon Lee, Jun Yong Choi
Infection & Chemotherapy.2019; 51(4): 365. CrossRef

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IBD

Distribution of cytomegalovirus genotypes among ulcerative colitis patients in Okinawa, Japan: Saifun Nahar, Akira Hokama, Atsushi Iraha, Tetsuya Ohira, Tetsu Kinjo, Tetsuo Hirata, Takeshi Kinjo, Gretchen L. Parrott, Jiro Fujita; Intest Res 2018;16(1):90-98. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.90

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Background/Aims

To determine the prevalence of glycoprotein B (gB), glycoprotein N (gN), and glycoprotein H (gH) genotypes of human cytomegalovirus (HCMV) superimposed on ulcerative colitis (UC) patients in Japan.

Methods

Four archived stool samples and 7-archived extracted DNA from stool samples of 11 UC patients with positive multiplex polymerase chain reaction (PCR) results for HCMV were used UL55 gene encoding gB, UL73 gene encoding gN, and UL75 gene encoding gH were identified by PCR. Genotypes of gB and glycoprotein N were determined by sequencing.

Results

Among 11 samples, 8 samples were amplified through PCR. gB, gN, and gH genotypes were successfully detected in 3 of 8 (37.5%), 4 of 8 (50%), and 8 of 8 (100%), respectively. The distribution of gB and gN genotypes analyzed through phylogenetic analysis were as follows: gB1 (2/3, 66.7%), gB3 (1/3, 33.3%), gN3a (2/4, 50%), and gN3b (2/4, 50%). Other gB genotypes (gB2 and gB4) and gN genotypes (gN1, gN2, and gN4) were not detected in this study. Out of successfully amplified 8 samples of gH genotype, gH1 and gH2 were distributed in 12.5% and 75% samples, respectively. Only 1 sample revealed mixed infection of gH genotype. The distribution of gH1 and gH2 differed significantly (1:6, P<0.05) in UC patients. The distribution of single gH genotype also revealed significant difference in UC patients who were treated with immunosuppressive drug (P<0.05).

Conclusions

In this study, gB1, gN3, and gH2 gene were determined as the most frequently observed genotypes in UC patients, which suggest that there might be an association between these genotypes of HCMV and UC.

Citations

Citations to this article as recorded by

Significance of Cytomegalovirus gB Genotypes in Adult Patients Undergoing Hematopoietic Stem Cell Transplantation: Insights from a Single-Centre Investigation
Tamara Vasiljevic, Marko Jankovic, Ana Tomic, Ida Bakrac, Stefan Radenovic, Danijela Miljanovic, Aleksandra Knezevic, Tanja Jovanovic, Irena Djunic, Milena Todorovic-Balint
Pharmaceuticals.2024; 17(4): 428. CrossRef
Cytomegalovirus Genotype Distribution among Congenital and Perinatal Infected Patients with CMV-Associated Thrombocytopenia
Hongbo Hu, Wenwen Peng, Qiaoying Peng, Ying Cheng
Fetal and Pediatric Pathology.2022; 41(1): 77. CrossRef
Cytomegalovirus Genotype and Virulence in Infants with Congenital Infection
Hong-bo Hu, Jian-gang Wu, Jian-jun Sun, Qiao-ying Peng, Xiao-peng Shang
Journal of Pediatric Infectious Diseases.2021; 16(04): 171. CrossRef
Common Polymorphisms in the Glycoproteins of Human Cytomegalovirus and Associated Strain-Specific Immunity
Hsuan-Yuan Wang, Sarah M. Valencia, Susanne P. Pfeifer, Jeffrey D. Jensen, Timothy F. Kowalik, Sallie R. Permar
Viruses.2021; 13(6): 1106. CrossRef
Cytomegalovirus and Inflammatory Bowel Diseases (IBD) with a Special Focus on the Link with Ulcerative Colitis (UC)
Alexandre Jentzer, Pauline Veyrard, Xavier Roblin, Pierre Saint-Sardos, Nicolas Rochereau, Stéphane Paul, Thomas Bourlet, Bruno Pozzetto, Sylvie Pillet
Microorganisms.2020; 8(7): 1078. CrossRef

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Infection

Rapid and accurate diagnosis of Clostridium difficile infection by real-time polymerase chain reaction: Pil Hun Song, Jung Hwa Min, You Sun Kim, Soo Yeon Jo, Eun Jin Kim, Kyung Jin Lee, Jeonghun Lee, Hyun Sung, Jeong Seop Moon, Dong Hee Whang; Intest Res 2018;16(1):109-115. Published online January 18, 2018; DOI: https://doi.org/10.5217/ir.2018.16.1.109

Abstract PDF PubReader ePub

Background/Aims

The incidence and severity of Clostridium difficile infection (CDI) have increased worldwide, resulting in a need for rapid and accurate diagnostic methods.

Methods

A retrospective study was conducted to compare CDI diagnosis methods between January 2014 and December 2014. The stool samples, which were obtained in presumptive CDI patients, were compared for their diagnostic accuracy and rapidity, including real-time polymerase chain reaction (PCR) of toxin genes, C. difficile toxin assay, and culture for C. difficile.

Results

A total of 207 cases from 116 patients were enrolled in this study and 117 cases (56.5%) were diagnosed as having CDI. Among the 117 cases, the sensitivities of real-time PCR, C. difficile toxin assay, and culture for C. difficile were 87.2% (102 cases; 95% CI, 80.7%–92.8%), 48.7% (57 cases; 95% CI, 41.0%–59.8%), and 65.0% (76 cases; 95% CI, 60.2%–78.5%), respectively (P<0.005). Notably, 34 cases (29.0%) were diagnosed with CDI by real-time PCR only. The time required to obtain results was 2.27 hours (136.62±82.51 minutes) for real-time PCR, 83.67 hours (5,020.66±3,816.38 minutes) for toxin assay, and 105.79 hours (6,347.68±3,331.46 minutes) for culture (P<0.005), respectively.

Conclusions

We confirmed that real-time PCR of toxin genes is the most effective diagnostic method for accurate and early diagnosis of CDI. It also helps to diagnose hypervirulent CDI, such as ribotype 027 infection.

Citations

Citations to this article as recorded by

Clostridium Difficile Infection in Childhood: Case Series
P. Parusheva, L. Pekova, S. Angelova, B. Bureva
Acta Medica Bulgarica.2025; 52(s1): 98. CrossRef
Usefulness of Stool Multiplex Polymerase Chain Reaction Assays in Patients with Acute Diarrhea
Seo Hyun Kim, You Sun Kim, Seung Hyuk Kim, Won Eui Yoon, Hee Jun Myung, Jeong Seop Moon, Dong Hee Whang
The Korean Journal of Gastroenterology.2022; 79(3): 118. CrossRef
Persistent Leg Drainage in a Pediatric Trauma Patient
Ashley Howard, Michelle R. Rychalsky, Thomas S. Murray
Pediatric Infectious Disease Journal.2021; 40(6): 597. CrossRef
Real-Time Detection and Motion Recognition of Human Moving Objects Based on Deep Learning and Multi-Scale Feature Fusion in Video
Meimei Gong, Yiming Shu
IEEE Access.2020; 8: 25811. CrossRef
Temporal change of risk factors in hospital-acquired Clostridioides difficile infection using time-trend analysis
Jiyoun Song, Bevin Cohen, Philip Zachariah, Jianfang Liu, Elaine L. Larson
Infection Control & Hospital Epidemiology.2020; 41(9): 1048. CrossRef
Incidence and Characteristics ofClostridioides difficileInfection in Children
Heera Jeong, Ji-Man Kang, Jong Gyun Ahn
Pediatric Infection & Vaccine.2020; 27(3): 158. CrossRef
RecurrentClostridium difficileInfection: Risk Factors, Treatment, and Prevention
Jung Hoon Song, You Sun Kim
Gut and Liver.2019; 13(1): 16. CrossRef
Is Clostridium difficile infection a real threat in patients with ulcerative colitis? A prospective, multicenter study in Korea
Dae Bum Kim, Kang-Moon Lee, Sang Hyoung Park, You Sun Kim, Eun Soo Kim, Jun Lee, Sung-Ae Jung, Geom Seog Seo, Ji Min Lee
Intestinal Research.2018; 16(2): 267. CrossRef

8,865 View
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