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Review
. 2022 Aug 25;80(2):66-71.
doi: 10.4166/kjg.2022.097.

[Clostridioides Infection in Patients with Inflammatory Bowel Disease]

[Article in Korean]
Mi Rae Lee  1 , Eun Soo Kim  1
Affiliations
Review

[Clostridioides Infection in Patients with Inflammatory Bowel Disease]

[Article in Korean]
Mi Rae Lee et al. Korean J Gastroenterol. .

Abstract
in English, Korean

Inflammatory bowel disease (IBD), comprising Crohn's disease and ulcerative colitis, is a chronic inflammatory condition of the gastrointestinal tract, which is often accompanied by altered gut microbial composition. Gut dysbiosis in IBD is considered to be the reason for the high risk of Clostridioides difficile infection (CDI) in patients with IBD. Therefore, CDI should be evaluated in IBD patients with a symptom flare. Medical treatment of non-severe CDI in IBD is similar to that in non-IBD patients and includes oral vancomycin or fidaxomicin. The risk of recurrent CDI in IBD is higher than in non-IBD patients and this could be mitigated by fecal microbiota transplantation. As CDI may worsen the clinical outcomes of IBD, patients should be carefully monitored and an escalation of IBD therapy needs to be considered when there is no improvement seen with the antimicrobial treatment of CDI. This review discusses the risk, pathophysiology, diagnosis, and management of CDI in IBD.

Inflammatory bowel disease (IBD), comprising Crohn’s disease and ulcerative colitis, is a chronic inflammatory condition of the gastrointestinal tract, which is often accompanied by altered gut microbial composition. Gut dysbiosis in IBD is considered to be the reason for the high risk of Clostridioides difficile infection (CDI) in patients with IBD. Therefore, CDI should be evaluated in IBD patients with a symptom flare. Medical treatment of non-severe CDI in IBD is similar to that in non-IBD patients and includes oral vancomycin or fidaxomicin. The risk of recurrent CDI in IBD is higher than in non-IBD patients and this could be mitigated by fecal microbiota transplantation. As CDI may worsen the clinical outcomes of IBD, patients should be carefully monitored and an escalation of IBD therapy needs to be considered when there is no improvement seen with the antimicrobial treatment of CDI. This review discusses the risk, pathophysiology, diagnosis, and management of CDI in IBD.

Keywords: Clostridioides difficile infection; Colitis, ulcerative; Crohn disease; Inflammatory bowel diseases.

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Conflict of interest statement

Conflict of interest

None.

Figures

Fig. 1
Fig. 1
Medical management of CDI in IBD. IBD, inflammatory bowel disease; CDI, Clostridioides difficile infection; FMT, fecal microbiota transplantation. aMetronidazole can be used if there is no risk of resistance to metronidazole; bFidaxomicin is not available in Korea currently.
See this image and copyright information in PMC

References

    1. Sood A, Kaur K, Mahajan R, et al. Colitis and Crohn's Foundation (India): a first nationwide inflammatory bowel disease registry. Intest Res. 2021;19:206–216. doi: 10.5217/ir.2019.09169. - DOI - PMC - PubMed
    1. Hong SW, Ye BD. The first step to unveil the epidemiology of inflammatory bowel disease in Central Asia. Intest Res. 2020;18:345–346. doi: 10.5217/ir.2020.00121. - DOI - PMC - PubMed
    1. Franzosa EA, Sirota-Madi A, Avila-Pacheco J, et al. Gut microbiome structure and metabolic activity in inflammatory bowel disease. Nat Microbiol. 2019;4:293–305. doi: 10.1038/s41564-018-0306-4. - DOI - PMC - PubMed
    1. Khanna S. Management of Clostridioides difficile infection in patients with inflammatory bowel disease. Intest Res. 2021;19:265–274. doi: 10.5217/ir.2020.00045. - DOI - PMC - PubMed
    1. McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA) Clin Infect Dis. 2018;66:987–994. doi: 10.1093/cid/ciy149. - DOI - PubMed

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