A262 CLOSTRIDIUM DIFFICILE INFECTION IN CHILDREN WITH INFLAMMATORY BOWEL DISEASE: A SINGLE CENTER CROSS-SECTIONAL STUDY
Notice bibliographique
Résumé
Many studies have reported a high incidence of Clostridium difficile infections (CDI) among patients with inflammatory bowel disease (IBD). It was also suggested that CDI occurrence and recurrence in IBD pediatric patients have been increasing in the last decades. The aim of this study was to assess the incidence and prevalence of CDI and to identify the associated risk factors in children diagnosed with IBD. This cross-sectional study included all children diagnosed with IBD between January 2011 and September 2018. CDI diagnosis was confirmed by the presence of Clostridium difficile toxin, detected by a cellular cytotoxicity test (before 2014) or Polymerase Chain Reaction test (after 2014). CDI at diagnosis was defined as a positive test seven days before or after IBD diagnosis. CDI prevalence was estimated according to the total number of patients and of CDI cases. Incidence was calculated according to the number of children exposed and follow-up days. Factors associated with CDI occurrence were investigated. During the study period, 767 patients (375 females) were diagnosed with IBD. The mean (SD) age at diagnosis was 13.1 (± 4.1) years old. Of these, 499 patients were diagnosed with Crohn’s disease (CD) (65.1%), 163 (21.2%) with ulcerative colitis (UC) and 105 (13.7%) with IBD unclassified (IBDU). A total of 43 (5.6%) patients had at least one episode of CDI, including 12 (1.6%) at diagnosis and 34 (4.4%) after diagnosis. Children who had at least one CDI were significantly younger at diagnosis (mean (SD) age 11.9 (± 4.1) years), as compared to those who were never infected (13.2 (± 3.4) years, P= 0.013). The rate of CDI was not different between females (6.7%) and males (4.6%) (P=0.402). CDI prevalence was higher in UC (11.7%) than CD (3.4%) or IBDU (6.7%) (P=0.0005). CDI recurrence was observed in 18.6% of children, with no significant difference according to age at diagnosis (P=0.219), sex (P=0.782) or diagnosis (P=0.212). For UC or IBDU patients with at least one episode of CDI (N = 26), 17 (65.4%) of them had pancolitis, compared to 9 (34.6%) with left side colitis/proctitis (P=0.002). In multivariate analysis, children were more likely to have CDI during follow-up if, at diagnosis, they had a pancolitis (OR=4.1, 95% CI: 1.6 – 10.5, P=0.003), an episode of CDI (OR=5.4, 95% CI: 1.2 – 24.2, P=0.027) and age < 10 years (OR=2.5, 95% CI: 1.2 – 5.4, P=0.016). Crohn’s colitis was associated with a higher prevalence of CDI as compared to isolated ileitis (5.0% and 1.0% respectively, P=0.021). The prevalence of CDI in our cohort (5.6%) falls within the range that is described in the literature. A young age at diagnosis, colitis in CD, pancolitis in CU and a history of CDI at diagnosis were found to be risk factors for CDI in children with IBD. None
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,001 | 0,002 |
| Méta-épidémiologie (sens strict) | 0,000 | 0,001 |
| Méta-épidémiologie (sens large) | 0,001 | 0,001 |
| Bibliométrie | 0,001 | 0,002 |
| Études des sciences et des technologies | 0,001 | 0,000 |
| Communication savante | 0,001 | 0,001 |
| Science ouverte | 0,000 | 0,001 |
| Intégrité de la recherche | 0,001 | 0,001 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,002 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».