Antibiotic-associated colitis in patients with tuberculosis in surgical practice
Abstract
Aims. To determine the incidence and clinical characteristics of tuberculosis medication-associated Clostridium difficile infection.
Methods. This single center study included patients from one hospital enrolled from 2013 to 2015. A retrospective analysis was conducted to identify the clinical features of C. difficile infection in patients who received TB medication.
Results. C. difficile infection developed in 36 of the 10675 patients prescribed TB medication, representing a total incidence of infection of 3.37 cases per 1,000 adults. 25 (69,4%) patients were treated with rifampin. The patients were usually treated with oral metronidazole, which produced improvement in 8 of the 12 (75,0%), combined treatment with oral vancomycin led to improvement in 7 of the 8 (87,5%). Rifampin was discontinued during CDI treatment for all patients. There were no significant differences in improvement between patients treated continuously (n=10) and patients in whom treatment was discontinued (n = 6).
Conclusion. The incidence of C. difficile infection after TB medication was not low considering the relatively low TB medication dosage compared to other antibiotics. It may not be always necessary to discontinue TB medication. Instead, decisions concerning discontinuation of TB medication should be based on TB status.
About the Authors
O. N. Zuban
ГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
M. N. Reshetnikov
ГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
M. S. Scopin
ГБУЗ «Московский городской научно-практический центр борьбы с туберкулезом Департамента здравоохранения города Москвы»
Russian Federation
Russian Federation
References
1. Корнеева О.Н., Ивашкин В.Т. Антибиотикоассоциированный колит: патоморфология, клиника, лечение // Российский журнал гастроэнтерологии, гепатологии, колопроктологии. – 2007. – № 3. – С. 65-69.
2. Нечаева О.Б. Предварительные результаты эпидемиологических показателей по туберкулезу за 2015 г. // IV Всероссийская научно-практическая конференция с международным участием «Актуальные вопросы профилактики, диагностики и лечения туберкулеза у детей и подростков». Ялта, 31 марта 2016 г.
3. Bauer M.P., Notermans D.W., van Benthem B.H. et al. Clostridium difficile infection in Europe: a hospital-based survey. // Lancet. – 2011. – Vol. 377. – P. 63-73.
4. Boriello S.P., Jones R.H., Phillips I. Rifampicin-associated pseudomembranous colitis. // Br. Med. J. – 1980. – Vol. 281. – P. 1180-1181.
5. Burke K.E, Lamont J.T. Clostridium difficile infection: a worldwide disease. // Gut Liver. – 2014. – Vol. 8. – Vol. 1-6.
6. Chen T.C., Lu P.L., Lin W.R. et al. Rifampin-associated pseudomembranous colitis. // Am. J. Med. Sci. – 2009. – Vol. 338. – P. 156- 158.
7. Cohen S.H., Gerding D.N., Johnson S. et al. Clinical practice guidelines for Clostridium difficile infection in adults: 2010 update by the society for healthcare epidemiology of America (SHEA) and the infectious diseases society of America (IDSA). // Infect. Control Hosp. Epidemiol. – 2010. – Vol. 31. – P. 431-455.
8. Fournier G., Orgiazzi J., Lenoir B., Dechavanne M. Pseudomembranous colitis probably due to rifampicin. // Lancet. – 1980. – N. 1 (8159). – P. 101.
9. Fujitani S., George W.I., Murthy A.R. Comparison of clinical severity score indices for Clostridium difficile infection. // Infect. Control Hosp. Epidemiol. – 2011. – Vol. 32. – N. 3. – P. 220-228.
10. Gravel D., Miller M., Simor A. et al. Health care-associated Clostridium difficile infection in adults admitted to acute care hospitals in Canada: a Canadian Nosocomial Infection Surveillance Program Study. // Clin. Infect. Dis. – 2009. – Vol. –48. – P. 568-576.
11. Gujja D., Friedenberg F.K. Predictors of serious complications due to Clostridium difficile infection. // Aliment. Pharmacol. Ther. – 2009. – Vol. 29. – P. 635-642.
12. Gweon T.G., Lee K.J., Kang D. et al. A case of toxic megacolon caused by Clostridium difficile infection and treated with fecal microbiota transplantation. // Gut Liver. – 2015. – Vol. 9. – P. 247-250.
13. Jung S.W., Jeon S.W., Do B.H., et al. Clinical aspects of rifampicin-associated pseudomembranous colitis. // J. Clin. Gastroenterol. – 2007. – Vol. 41. – P. 38-40.
14. Karas J.A., Enoch D.A., Aliyu S.H. A review of mortality due to Clostridium difficile infection. // J. Infect. – 2010. – Vol. 61. – P. 1-8.
15. Kelly C.P., Pothoulakis C., LaMont J.T. Clostridium difficile colitis. // N. Engl. J. Med. – 1994. – Vol. 330. – P. 257-262.
16. Kim Y.S., Han D.S., Kim Y.H. et al. Incidence and clinical features of Clostridium difficile infection in Korea: a nationwide study. // Epidemiol. Infect. // 2013. – Vol. 141. – P. 189-194.
17. Klaui H, Leuenberger P. Pseudomembranous colitis due to rifampicin. // Lancet. – 1981. – N. 2 (8258). – P. 1294.
18. Kyne L., Warny M., Qamar A., Kelly C.P. Asymptomatic carriage of Clostridium difficile and serum levels of IgG antibody against toxin A. // N. Engl. J. Med. – 2000. – Vol. 342. – P. 390-397.
19. Lee Y.M., Huh K.C., Yoon S.M. et al. Incidence and clinical outcomes of Clostridium difficile infection after treatment with tuberculosis medication. // Gut Liver. – 2016. – Vol. 10. – N. 2. – P. 250-254.
20. Nakajima A., Yajima S., Shirakura T. et al. Rifampicin-associated pseudomembranous colitis. // J. Gastroenterol. – 2000. – Vol. 35. – P. 299-303.
21. Park J.Y., Kim J.S., Jeung S.J. et al. A case of pseudomembranous colitis associated with rifampin. // Korean J. Intern. Med. – 2004. – Vol. 19. – P. 261-265.
22. Seo G.S. Clostridium difficile infection: what’s new? // Intest. Res. – 2013. – Vol. 11. – P. 1-13.
23. Surawicz C.M. Brandt L.J., Binion D.G. et al. Guidelines for diagnosis, treatment, and prevention of Clostridium difficile infections. // Am. J. Gastroenterol. – 2013. – Vol. 108. – P. 478-498.
24. Yim S.Y., Koo J.S., Kim Y.J. et al. Rifampin-induced pseudomembranous colitis with rectosigmoid sparing. // Clin. Endosc. – 2011. – Vol. 44. – P. 137-139.
Review
For citations:
Zuban O.N., Reshetnikov M.N., Scopin M.S. Antibiotic-associated colitis in patients with tuberculosis in surgical practice. Tuberculosis and socially significant diseases. 2016;(5):30-35. (In Russ.)
Views:
6
Email this article 