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. 1982 May;23(5):410–414. doi: 10.1136/gut.23.5.410

Clostridium difficile toxin in acute diarrhoea complicating inflammatory bowel disease.

M R Keighley, D Youngs, M Johnson, R N Allan, D W Burdon
PMCID: PMC1419689  PMID: 7076018

Abstract

The incidence of Clostridium difficile cytotoxin has been studied in 69 consecutive patients with inflammatory bowel disease complicated by severe diarrhoea or ileostomy flux during 74 admissions to hospital. The cytotoxin was identified in only four patients, all of whom had received antimicrobials. Clostridium difficle, but not cytotoxin, was identified in 10 of 43 admissions. This followed antimicrobial prophylaxis to cover a recent operation in two patients, and five were on long-term sulphasalazine. Only three patients with Clostridium difficile had not received an antimicrobial within one month of the study. Isolation of Clostridium difficile alone is of doubtful pathological significance, as it spontaneously disappeared without treatment in all patients.

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Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Arabi Y., Dimock F., Burdon D. W., Alexander-Williams J., Keighley M. R. Influence of bowel preparation and antimicrobials on colonic microflora. Br J Surg. 1978 Aug;65(8):555–558. doi: 10.1002/bjs.1800650809. [DOI] [PubMed] [Google Scholar]
  2. Bartlett J. G., Chang T. W., Gurwith M., Gorbach S. L., Onderdonk A. B. Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med. 1978 Mar 9;298(10):531–534. doi: 10.1056/NEJM197803092981003. [DOI] [PubMed] [Google Scholar]
  3. Bolton R. P., Sherriff R. J., Read A. E. Clostridium difficile associated diarrhoea: a role in inflammatory bowel disease? Lancet. 1980 Feb 23;1(8165):383–384. doi: 10.1016/s0140-6736(80)90940-x. [DOI] [PubMed] [Google Scholar]
  4. Burdon D. W., Keighley M. R., Allan R. N., George R. H. Clostridial toxin in inflammatory bowel disease. Lancet. 1980 Jun 28;1(8183):1421–1422. doi: 10.1016/s0140-6736(80)92691-4. [DOI] [PubMed] [Google Scholar]
  5. George W. L., Sutter V. L., Finegold S. M. Antimicrobial agent-induced diarrhea--a bacterial disease. J Infect Dis. 1977 Dec;136(6):822–828. doi: 10.1093/infdis/136.6.822. [DOI] [PubMed] [Google Scholar]
  6. Keighley M. R., Arabi Y., Alexander-Williams J., Youngs D., Burdon D. W. Comparison between systemic and oral antimicrobial prophylaxis in colorectal surgery. Lancet. 1979 Apr 28;1(8122):894–897. doi: 10.1016/s0140-6736(79)91373-4. [DOI] [PubMed] [Google Scholar]
  7. Keighley M. R., Burdon D. W., Alexander-Williams J., Shinagawa N., Arabi Y., Thompson H., Youngs D., Bentley S., George R. H. Diarrhoea and pseudomembranous colitis after gastrointestinal operations. A prospective study. Lancet. 1978 Dec 2;2(8101):1165–1167. doi: 10.1016/s0140-6736(78)92151-7. [DOI] [PubMed] [Google Scholar]
  8. Keighley M. R., Burdon D. W., Arabi Y., Williams J. A., Thompson H., Youngs D., Johnson M., Bentley S., George R. H., Mogg G. A. Randomised controlled trial of vancomycin for pseudomembranous colitis and postoperative diarrhoea. Br Med J. 1978 Dec 16;2(6153):1667–1669. doi: 10.1136/bmj.2.6153.1667. [DOI] [PMC free article] [PubMed] [Google Scholar]
  9. Krook A., Danielsson D., Kjellander J., Järnerot G. Changes in the fecal flora of patients with Crohn's disease during treatment with metronidazole. A preliminary report. Scand J Gastroenterol. 1979;14(6):705–710. doi: 10.3109/00365527909181941. [DOI] [PubMed] [Google Scholar]
  10. LaMont J. T., Trnka Y. M. Therapeutic implications of Clostridium difficile toxin during relapse of chronic inflammatory bowel disease. Lancet. 1980 Feb 23;1(8165):381–383. doi: 10.1016/s0140-6736(80)90939-3. [DOI] [PubMed] [Google Scholar]
  11. Larson H. E., Price A. B., Honour P., Borriello S. P. Clostridium difficile and the aetiology of pseudomembranous colitis. Lancet. 1978 May 20;1(8073):1063–1066. doi: 10.1016/s0140-6736(78)90912-1. [DOI] [PubMed] [Google Scholar]
  12. Lishman A. H., Al-Jumaili I. J., Record C. O. Spectrum of antibiotic-associated diarrhoea. Gut. 1981 Jan;22(1):34–37. doi: 10.1136/gut.22.1.34. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Lusk R. H., Fekety R., Silva J., Browne R. A., Ringler D. H., Abrams G. D. Clindamycin-induced enterocolitis in hamsters. J Infect Dis. 1978 Apr;137(4):464–475. doi: 10.1093/infdis/137.4.464. [DOI] [PubMed] [Google Scholar]
  14. Mogg G. A., Keighley M. R., Burdon D. W., Alexander-Williams J., Youngs D., Johnson M., Bentley S., George R. H. Antibiotic-associated colitis--a review of 66 cases. Br J Surg. 1979 Oct;66(10):738–742. doi: 10.1002/bjs.1800661017. [DOI] [PubMed] [Google Scholar]
  15. Price A. B., Davies D. R. Pseudomembranous colitis. J Clin Pathol. 1977 Jan;30(1):1–12. doi: 10.1136/jcp.30.1.1. [DOI] [PMC free article] [PubMed] [Google Scholar]
  16. Rietra P. J., Slaterus K. W., Zanen H. C., Meuwissen S. G. Clostridial toxin in faeces of healthy infants. Lancet. 1978 Aug 5;2(8084):319–319. doi: 10.1016/s0140-6736(78)91723-3. [DOI] [PubMed] [Google Scholar]

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