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Correlation between coinfection with parasites, cytomegalovirus, and Clostridium difficile and disease severity in patients with ulcerative colitis
A cross-sectional study was undertaken to determine whether there was any association between intestinal infection (with parasites, cytomegalovirus, or Clostridium difficile ) and clinical disease severity in patients with ulcerative colitis (UC). Consecutive cases of UC were enrolled after history...
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| Published in: | Indian journal of gastroenterology 2013-03, Vol.32 (2), p.115-118 |
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| container_end_page | 118 |
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| container_title | Indian journal of gastroenterology |
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| creator | Iyer, Venkatakrishnan H. Augustine, Joby Pulimood, Anna B. Ajjampur, Sitara Swarna Rao Ramakrishna, Balakrishnan S. |
| description | A cross-sectional study was undertaken to determine whether there was any association between intestinal infection (with parasites, cytomegalovirus, or
Clostridium difficile
) and clinical disease severity in patients with ulcerative colitis (UC). Consecutive cases of UC were enrolled after history and clinical examination, evaluated for presence of stool parasites (routine/special stains) and
C. difficile
toxins A and B (CDT) in stools. Segmental biopsies at colonoscopy were assessed for cytopathic changes of cytomegalovirus (CMV) infection. Statistical analysis was done to look for associations between the presence of infection and disease severity as assessed by the Truelove–Witts criteria. Eighty-seven patients (males = 51) of mean (SD) age 40.2 (12) years were enrolled. Thirty-nine patients (44.8 %) had severe disease, 11 (12.6 %) had moderate, and 37 (42.6 %) had mild disease. Ten (11.5 %) patients had parasites detected in stool, two (2.3%) had histological evidence of CMV, and three (3.4 %) were positive for CDT. The presence of pathogens was very significantly associated with moderate/severe UC. Thirteen of 15 cases (86 %) with detectable pathogens had moderate or severe UC compared to 37 of 72 cases (51 %) without detectable pathogens (
p
= 0.0194). The relative risk of a UC patient with stool pathogens having severe disease was 1.686 (95 % CI 1.250 to 2.276) compared to one without stool pathogens. The presence of stool pathogens was associated with disease severity in UC. |
| doi_str_mv | 10.1007/s12664-012-0302-1 |
| format | article |
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Clostridium difficile
) and clinical disease severity in patients with ulcerative colitis (UC). Consecutive cases of UC were enrolled after history and clinical examination, evaluated for presence of stool parasites (routine/special stains) and
C. difficile
toxins A and B (CDT) in stools. Segmental biopsies at colonoscopy were assessed for cytopathic changes of cytomegalovirus (CMV) infection. Statistical analysis was done to look for associations between the presence of infection and disease severity as assessed by the Truelove–Witts criteria. Eighty-seven patients (males = 51) of mean (SD) age 40.2 (12) years were enrolled. Thirty-nine patients (44.8 %) had severe disease, 11 (12.6 %) had moderate, and 37 (42.6 %) had mild disease. Ten (11.5 %) patients had parasites detected in stool, two (2.3%) had histological evidence of CMV, and three (3.4 %) were positive for CDT. The presence of pathogens was very significantly associated with moderate/severe UC. Thirteen of 15 cases (86 %) with detectable pathogens had moderate or severe UC compared to 37 of 72 cases (51 %) without detectable pathogens (
p
= 0.0194). The relative risk of a UC patient with stool pathogens having severe disease was 1.686 (95 % CI 1.250 to 2.276) compared to one without stool pathogens. The presence of stool pathogens was associated with disease severity in UC.</description><identifier>ISSN: 0254-8860</identifier><identifier>EISSN: 0975-0711</identifier><identifier>DOI: 10.1007/s12664-012-0302-1</identifier><identifier>PMID: 23408260</identifier><language>eng</language><publisher>India: Springer-Verlag</publisher><subject>Adult ; Bacterial Proteins - analysis ; Bacterial Toxins - analysis ; Clostridium difficile - isolation & purification ; Coinfection ; Colitis, Ulcerative - complications ; Colon - virology ; Cytomegalovirus Infections - complications ; Enterocolitis, Pseudomembranous - complications ; Enterocolitis, Pseudomembranous - microbiology ; Enterotoxins - analysis ; Feces - chemistry ; Feces - parasitology ; Female ; Gastroenterology ; Hepatology ; Humans ; Intestinal Diseases, Parasitic - complications ; Male ; Medicine ; Medicine & Public Health ; Middle Aged ; Severity of Illness Index ; Short Report</subject><ispartof>Indian journal of gastroenterology, 2013-03, Vol.32 (2), p.115-118</ispartof><rights>Indian Society of Gastroenterology 2013</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c344t-7eb076dabb8f0c666bd59b44dbca1a09b6f76972a4fcee5f6c5d175ed8cabc513</citedby><cites>FETCH-LOGICAL-c344t-7eb076dabb8f0c666bd59b44dbca1a09b6f76972a4fcee5f6c5d175ed8cabc513</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,786,790,27957,27958</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/23408260$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Iyer, Venkatakrishnan H.</creatorcontrib><creatorcontrib>Augustine, Joby</creatorcontrib><creatorcontrib>Pulimood, Anna B.</creatorcontrib><creatorcontrib>Ajjampur, Sitara Swarna Rao</creatorcontrib><creatorcontrib>Ramakrishna, Balakrishnan S.</creatorcontrib><title>Correlation between coinfection with parasites, cytomegalovirus, and Clostridium difficile and disease severity in patients with ulcerative colitis</title><title>Indian journal of gastroenterology</title><addtitle>Indian J Gastroenterol</addtitle><addtitle>Indian J Gastroenterol</addtitle><description>A cross-sectional study was undertaken to determine whether there was any association between intestinal infection (with parasites, cytomegalovirus, or
Clostridium difficile
) and clinical disease severity in patients with ulcerative colitis (UC). Consecutive cases of UC were enrolled after history and clinical examination, evaluated for presence of stool parasites (routine/special stains) and
C. difficile
toxins A and B (CDT) in stools. Segmental biopsies at colonoscopy were assessed for cytopathic changes of cytomegalovirus (CMV) infection. Statistical analysis was done to look for associations between the presence of infection and disease severity as assessed by the Truelove–Witts criteria. Eighty-seven patients (males = 51) of mean (SD) age 40.2 (12) years were enrolled. Thirty-nine patients (44.8 %) had severe disease, 11 (12.6 %) had moderate, and 37 (42.6 %) had mild disease. Ten (11.5 %) patients had parasites detected in stool, two (2.3%) had histological evidence of CMV, and three (3.4 %) were positive for CDT. The presence of pathogens was very significantly associated with moderate/severe UC. Thirteen of 15 cases (86 %) with detectable pathogens had moderate or severe UC compared to 37 of 72 cases (51 %) without detectable pathogens (
p
= 0.0194). The relative risk of a UC patient with stool pathogens having severe disease was 1.686 (95 % CI 1.250 to 2.276) compared to one without stool pathogens. The presence of stool pathogens was associated with disease severity in UC.</description><subject>Adult</subject><subject>Bacterial Proteins - analysis</subject><subject>Bacterial Toxins - analysis</subject><subject>Clostridium difficile - isolation & purification</subject><subject>Coinfection</subject><subject>Colitis, Ulcerative - complications</subject><subject>Colon - virology</subject><subject>Cytomegalovirus Infections - complications</subject><subject>Enterocolitis, Pseudomembranous - complications</subject><subject>Enterocolitis, Pseudomembranous - microbiology</subject><subject>Enterotoxins - analysis</subject><subject>Feces - chemistry</subject><subject>Feces - parasitology</subject><subject>Female</subject><subject>Gastroenterology</subject><subject>Hepatology</subject><subject>Humans</subject><subject>Intestinal Diseases, Parasitic - complications</subject><subject>Male</subject><subject>Medicine</subject><subject>Medicine & Public Health</subject><subject>Middle Aged</subject><subject>Severity of Illness Index</subject><subject>Short Report</subject><issn>0254-8860</issn><issn>0975-0711</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2013</creationdate><recordtype>article</recordtype><recordid>eNp9kc1u1TAQhS0EoqXlAdigLFkQsB3HSZboqvxIldi0a8s_k-LKsS8e51b3OXjh-jaFJSuPz5z5RvYh5B2jnxilw2dkXErRUsZb2lHeshfknE5D39KBsZe15r1ox1HSM_IG8Z6e7lP3mpzxTtCRS3pO_uxSzhB08Sk2BsoDQGxs8nEG-6Q9-PKr2eus0RfAj409lrTAnQ7p4PNaBR1dswsJS_bOr0vj_Dx76wM8dZxH0AgNwgGyL8fGx0orHmLBjb0GC7kqB6h7gy8eL8mrWQeEt8_nBbn9enWz-95e__z2Y_flurWdEKUdwNBBOm3MOFMrpTSun4wQzljNNJ2MnAc5DVyL2QL0s7S9Y0MPbrTa2J51F-TDxt3n9HsFLGrxaCEEHSGtqFjHJRNUyKla2Wa1OSFmmNU--0Xno2JUnbJQWxaqZqFOWagT_v0zfjULuH8Tfz-_GvhmwNqKd5DVfVpzrE_-D_URyM2Zxw</recordid><startdate>20130301</startdate><enddate>20130301</enddate><creator>Iyer, Venkatakrishnan H.</creator><creator>Augustine, Joby</creator><creator>Pulimood, Anna B.</creator><creator>Ajjampur, Sitara Swarna Rao</creator><creator>Ramakrishna, Balakrishnan S.</creator><general>Springer-Verlag</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20130301</creationdate><title>Correlation between coinfection with parasites, cytomegalovirus, and Clostridium difficile and disease severity in patients with ulcerative colitis</title><author>Iyer, Venkatakrishnan H. ; Augustine, Joby ; Pulimood, Anna B. ; Ajjampur, Sitara Swarna Rao ; Ramakrishna, Balakrishnan S.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c344t-7eb076dabb8f0c666bd59b44dbca1a09b6f76972a4fcee5f6c5d175ed8cabc513</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2013</creationdate><topic>Adult</topic><topic>Bacterial Proteins - analysis</topic><topic>Bacterial Toxins - analysis</topic><topic>Clostridium difficile - isolation & purification</topic><topic>Coinfection</topic><topic>Colitis, Ulcerative - complications</topic><topic>Colon - virology</topic><topic>Cytomegalovirus Infections - complications</topic><topic>Enterocolitis, Pseudomembranous - complications</topic><topic>Enterocolitis, Pseudomembranous - microbiology</topic><topic>Enterotoxins - analysis</topic><topic>Feces - chemistry</topic><topic>Feces - parasitology</topic><topic>Female</topic><topic>Gastroenterology</topic><topic>Hepatology</topic><topic>Humans</topic><topic>Intestinal Diseases, Parasitic - complications</topic><topic>Male</topic><topic>Medicine</topic><topic>Medicine & Public Health</topic><topic>Middle Aged</topic><topic>Severity of Illness Index</topic><topic>Short Report</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Iyer, Venkatakrishnan H.</creatorcontrib><creatorcontrib>Augustine, Joby</creatorcontrib><creatorcontrib>Pulimood, Anna B.</creatorcontrib><creatorcontrib>Ajjampur, Sitara Swarna Rao</creatorcontrib><creatorcontrib>Ramakrishna, Balakrishnan S.</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>Indian journal of gastroenterology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Iyer, Venkatakrishnan H.</au><au>Augustine, Joby</au><au>Pulimood, Anna B.</au><au>Ajjampur, Sitara Swarna Rao</au><au>Ramakrishna, Balakrishnan S.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Correlation between coinfection with parasites, cytomegalovirus, and Clostridium difficile and disease severity in patients with ulcerative colitis</atitle><jtitle>Indian journal of gastroenterology</jtitle><stitle>Indian J Gastroenterol</stitle><addtitle>Indian J Gastroenterol</addtitle><date>2013-03-01</date><risdate>2013</risdate><volume>32</volume><issue>2</issue><spage>115</spage><epage>118</epage><pages>115-118</pages><issn>0254-8860</issn><eissn>0975-0711</eissn><notes>ObjectType-Article-1</notes><notes>SourceType-Scholarly Journals-1</notes><notes>ObjectType-Feature-2</notes><notes>content type line 23</notes><abstract>A cross-sectional study was undertaken to determine whether there was any association between intestinal infection (with parasites, cytomegalovirus, or
Clostridium difficile
) and clinical disease severity in patients with ulcerative colitis (UC). Consecutive cases of UC were enrolled after history and clinical examination, evaluated for presence of stool parasites (routine/special stains) and
C. difficile
toxins A and B (CDT) in stools. Segmental biopsies at colonoscopy were assessed for cytopathic changes of cytomegalovirus (CMV) infection. Statistical analysis was done to look for associations between the presence of infection and disease severity as assessed by the Truelove–Witts criteria. Eighty-seven patients (males = 51) of mean (SD) age 40.2 (12) years were enrolled. Thirty-nine patients (44.8 %) had severe disease, 11 (12.6 %) had moderate, and 37 (42.6 %) had mild disease. Ten (11.5 %) patients had parasites detected in stool, two (2.3%) had histological evidence of CMV, and three (3.4 %) were positive for CDT. The presence of pathogens was very significantly associated with moderate/severe UC. Thirteen of 15 cases (86 %) with detectable pathogens had moderate or severe UC compared to 37 of 72 cases (51 %) without detectable pathogens (
p
= 0.0194). The relative risk of a UC patient with stool pathogens having severe disease was 1.686 (95 % CI 1.250 to 2.276) compared to one without stool pathogens. The presence of stool pathogens was associated with disease severity in UC.</abstract><cop>India</cop><pub>Springer-Verlag</pub><pmid>23408260</pmid><doi>10.1007/s12664-012-0302-1</doi><tpages>4</tpages></addata></record> |
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| subjects | Adult Bacterial Proteins - analysis Bacterial Toxins - analysis Clostridium difficile - isolation & purification Coinfection Colitis, Ulcerative - complications Colon - virology Cytomegalovirus Infections - complications Enterocolitis, Pseudomembranous - complications Enterocolitis, Pseudomembranous - microbiology Enterotoxins - analysis Feces - chemistry Feces - parasitology Female Gastroenterology Hepatology Humans Intestinal Diseases, Parasitic - complications Male Medicine Medicine & Public Health Middle Aged Severity of Illness Index Short Report |
| title | Correlation between coinfection with parasites, cytomegalovirus, and Clostridium difficile and disease severity in patients with ulcerative colitis |
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