Clostridium Difficile Infection and Inflammatory Bowel Disease: What Gastroenterologists and Surgeons Should Know
C. Cojocariu, A. Trifan, O. Stoica, C.A. Chihaia, C. StanciuEditorial, no. 5, 2014
Over the past two decades there has been a dramatic increaseworldwide in both incidence and severity of Clostridiumdifficile infection (CDI). Paralleling the rising incidence of CDIin the general population, there has been an even higherincrease in the incidence of CDI among patients with inflammatorybowel disease (IBD). CDI may mimic a flare of IBD assymptoms and laboratory parameters are often similar, andtherefore, screening for CDI is recommended at every flare insuch patients. Enzyme immunoassay to detect Clostridium difficile toxin A and B in stool is still the most widely used testfor CDI diagnosis despite its low sensitivity. Metronidazole formild moderate CDI, and vancomycin for severe CDI arethe preferred agents for the treatment of infection. CDI has anegative impact both on short- and long- term IBD outcomes,increasing the need for surgery, as well as the mortality rate andhealthcare costs. All gastroenterologists and surgeons shouldhave a high index of suspicion for CDI when evaluating apatient with IBD flare, as prompt diagnosis and adequatetreatment of infection improve outcomes. Measures must betaken to prevent spreading of infection in gastroenterology surgery settings.
