Nisan 2011
Hafif ve orta aktiviteli inflamatuvar barsak hastalarinda toksin A/B sikligi
Toxin A and B frequency in mildly and moderately active inflammatory bowel disease patients
- Ana Sayfa
- Sayılar
- Nisan 2011
- Hafif ve orta aktiviteli inflamatuvar barsak hastalarinda toksin A/B sikligi...
Özet
Giris ve Amaç: Inflamatuvar barsak hastaligi olan hastalar sik hastaneye yatis ve immünsüpresif/immünmodülatör ilaç ve antibiyotik kullanimi nedeniyle Clostridium difficile enfeksiyonu açisindan artmis riske sahiptir. Clostridium difficile enfeksiyonu sikligi hastalik aktivitesiyle paralel olarak artar. Bu çalismadaki amacimiz hafif ve orta aktiviteli inflamatuvar barsak hastalarinda toksin A/B sikligini arastirmaktir. Gereç ve Yöntem: Son üç ayda hastaneye yatis ve/ya antibiyotik kullanim öyküsü olmayan 100 inflamatuvar barsak hastasi (48 kadin, 52 erkek) çalismaya alindi. Her hastadan bir adet diski örnegi alinip EIA metoduyla Clostridium difficile toksin A/B açisindan çalisildi. Ek olarak diski örnekleri parazit açisindan incelendi ve örneklerin kültürü yapildi. Toksin A/B açisindan pozitif ve negatif olan hastalar yas, cinsiyet, hastalik tipi (Crohn hastaligi, ülseratif kolit), lokalizasyonu ve süresi, ektsraintestinal bulgular ve kullanilan ilaçlar (azatioprin, salazoprin, metotreksat, infliximab ve adalimumab) açisindan karsilastirildi. Bulgular: Clostridium difficile toksin A/B pozitifligi sadece iki hastada saptandi (1 erkek, 1 kadin). Iki grup arasinda karsilastirilan parametreler açisindan anlamli bir fark saptanmadi. Diski örneklerinde parazit saptanmadi ve diski kültürlerinde herhangi bir üreme olmadi. Sonuçlar: Hafif ve orta aktiviteli inflamatuvar barsak hastalarinda Clostridium difficile toksin A/B pozitifligi normal popülasyonla benzerdir ve sikligi daha önce düsünüldügü kadar yüksek degildir.
Abstract
Background/aims: Inflammatory bowel disease patients are at an increased risk for Clostridium difficile infection because of frequent hospitalizations and usage of immunosuppressive/immunomodulator drugs as well as antibiotics. The frequency of Clostridium difficile infection increases in parallel with the increase in disease activity. We aimed to evaluate the frequency of Clostridium difficile toxin A/B in patients with mildly and moderately active inflammatory bowel disease because a search on PubMed revealed a scarcity of literature knowledge in this regard. Methods: One hundred inflammatory bowel disease patients (48 females, 52 males) with mild and moderate activity were consecutively enrolled in the study; none of the patients had a history of hospitalization and/or antibiotic usage for the last three months. A stool sample was investigated for Clostridium difficile toxin A/B with enzyme immunoassay method by a microbiologist who was blinded to the study. Additionally, samples were evaluated for parasites and culture. Toxin A/B-positive and -negative cases were compared according to age, gender, disease type (Crohn?s disease, ulcerative colitis), duration and location, extraintestinal findings, and any drugs used (azathioprine, salazopyrin, methotrexate, infliximab, adalimumab). Results were evaluated statistically. Results: Clostridium difficile toxin A/B positivity was found in only two patients (1 female, 1 male) (2%). In comparisons, we found no significant differences between the two groups. There was no growth in stool cultures and no parasite was found in stool samples. Conclusions: Clostridium difficile toxin A/B positivity in mildly and moderately active inflammatory bowel disease patients is the same as in the normal population and not higher as hypothesized.
