PDF(Pubmed)
Abstract：
Children with inflammatory bowel disease (IBD) have an increased susceptibility to Clostridium difficile infection (CDI), with a rising incidence over time. Differentiating between CDI and IBD exacerbation is challenging due to overlapping symptoms. In our cohort of 55 pediatric IBD patients, 6 were diagnosed with CDI. Upon conducting a thorough patient evaluation and subsequent data analysis, an exhaustive review of the existing literature was undertaken. CDI is more prevalent in ulcerative colitis (UC) than Crohn\'s disease (CD) patients, as seen in our patients and in the existing literature. The management of a pediatric patient with IBD is itself a challenge for a clinician because of the chronic, possibly relapsing course, and substantial long-term morbidity. When CDI is added, it becomes even more demanding, since CDI leads to more severe disease in children with IBD. A multidisciplinary approach and intensive treatment for possible sepsis, anemia, hypoalbuminemia, and hydro-electrolytic and acid-base imbalances are frequently mandatory in patients with CDI and IBD, which leads to a significant health care burden in hospitalized children with IBD. After the infection is treated with antibiotic therapy, important considerations regarding the future treatment for the underlying IBD are also necessary; in most cases, a treatment escalation is required, as also seen in our study group.
摘要：
炎症性肠病（IBD）患儿对艰难梭菌感染（CDI）的易感性增加，随着时间的推移发病率不断上升。由于重叠症状，区分CDI和IBD恶化具有挑战性。在我们55名儿科IBD患者的队列中，6例确诊为CDI。在进行全面的患者评估和随后的数据分析后，对现有文献进行了详尽的回顾。CDI在溃疡性结肠炎（UC）中比克罗恩病（CD）患者更普遍，如我们的患者和现有文献所示。儿科IBD患者的管理本身对临床医生来说是一个挑战，因为慢性，可能是复发的过程，和大量的长期发病率。当添加CDI时，它变得更加苛刻，因为CDI在IBD儿童中导致更严重的疾病。多学科方法和强化治疗可能的败血症，贫血,低蛋白血症,在CDI和IBD患者中，水电解质和酸碱失衡通常是强制性的，这导致住院IBD儿童的重大医疗保健负担。在感染用抗生素治疗后，关于潜在IBD的未来治疗的重要考虑也是必要的；在大多数情况下，需要治疗升级，在我们的研究小组中也可以看到。
