Evidence map›Paper›PMID 29926235›Full record

ArticleInternational journal of colorectal disease2018

Impact of superimposed Clostridium difficile infection in Crohn's or ulcerative colitis flares in the outpatient setting.

Patrícia Guedes Garcia, Liliana Andrade Chebli, Tarsila Campanha da Rocha Ribeiro, Pedro Duarte Gaburri, Fabio Heleno de Lima Pace, Kátia Valéria Bastos Dias Barbosa, Lívia Almeida Costa, William de Almeida Cruz, Isabelle Carvalho de Assis, Bernardo Rodriguez Mendes Moraes and 2 more

Abstract read
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In one paragraph

Article in International journal of colorectal disease, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
0.9field-weighted citation impact, top 28% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 21 citations in OpenAlex.

  1. Trial
  2. Article
  3. Association ofWorld journal of gastrointestinal surgery · 2025
    Article
  4. Review
  5. Article
  6. Inflammatory bowel disease andTherapeutic advances in gastroenterology · 2023
    Review
  7. Review
  8. Review
  9. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors at 1 institution in 1 country.

Patrícia Guedes GarciaDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Liliana Andrade ChebliDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.ORCID http://orcid.org/0000-0003-1527-0663
Tarsila Campanha da Rocha RibeiroDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Pedro Duarte GaburriDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Fabio Heleno de Lima PaceDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Kátia Valéria Bastos Dias BarbosaDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Lívia Almeida CostaDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
William de Almeida CruzDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Isabelle Carvalho de AssisDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Bernardo Rodriguez Mendes MoraesDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Alexandre ZaniniDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil.
Julio Maria Fonseca ChebliDivision of Gastroenterology, Department of Medicine, Inflammatory Bowel Diseases Center, University Hospital of the Federal University of Juiz de Fora, University of Juiz de Fora School of Medicine, Maria José Leal Street, 296, Juiz de Fora, MG, CEP 36036-247, Brazil. chebli@globo.com.
Universidade Federal de Juiz de Fora · BR

Funding

National Council of Scientific Researches (CNPq), Brazil Non applicable
6 · The paper itself

Abstract

purposeThe prospective assessment of Clostridium difficile infection (CDI) impact in inflammatory bowel disease (IBD) flare in outpatient setting has been poorly investigated. We aimed to evaluate the prevalence and the associated factors with CDI in IBD outpatients presenting colitis flares as well as the outcomes following treatment.

methodsIn this prospective cohort study, conducted from October, 2014, to July, 2016, 120 IBD patients (55% presenting colitis flare) and 40 non-IBD controls were assessed for CDI. Multivariate regression analysis was performed to identify predictors of CDI. Outcome analysis was estimated for recurrent CDI, hospitalization, colectomy, and CDI-associated mortality.

resultsThe number of patients with CDI was significantly higher in IBD patients experiencing flares than in both inactive IBD and non-IBD groups (28.8 vs. 5.6 vs. 0%, respectively; p = 0.001). Females (OR = 1.39, 95% CI, 1.13-17.18), younger age (OR = 0.77, 95% CI, 0.65-0.92), steroid treatment (OR = 7.42, 95% CI, 5.17-40.20), and infliximab therapy (OR = 2.97, 95% CI, 1.99-24.63) were found to be independently associated with CDI. There was a dose-related increase in the risks of CDI on patients which had taken prednisone. Those treated with vancomycin had a satisfactory response to therapy, but 21% presented recurrent CDI and 16% were hospitalized. Neither necessity of colectomy nor mortality was noticed in any patient during the investigation.

conclusionsIn IBD outpatients presenting colitis flares, CDI is highly prevalent. Females, younger age, infliximab, and notably steroid therapy were independently associated with CDI. Most patients with CDI experienced mild-to-moderate disease, and prompt treatment with vancomycin was highly effective, which seems to reduce the serious complication risks.

Indexed as

Ambulatory CareAdultAge FactorsAnti-Bacterial AgentsAnti-Inflammatory AgentsBrazilClostridium InfectionsColitis, UlcerativeCrohn DiseaseDisease ProgressionFemaleHumansInfliximabMaleMiddle AgedPrevalenceAnti-Bacterial AgentsAnti-Inflammatory AgentsInfliximabSteroidsVancomycinClostridium difficileColitisCrohn’s diseaseInflammatory bowel diseaseUlcerative colitis

Identifiers

PMID29926235
OpenAlexW2809076541

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.