The Occurrence of Clostridium difficile Toxin in Ulcerative Colitis

The occurrence of Clostridium dificile toxin in feces was studied in 17 cases of ulcerative colitis (mild, 5 ; moderate, 11 ; severe, 1) (initial attack, 1 ; relapsing-remitting, 15 ; chronic persistent, 1). Toxin was demonstrated in only two of the 17 cases (11.8%). In one of these two cases, antib...

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Published inNippon Daicho Komonbyo Gakkai Zasshi Vol. 41; no. 6; pp. 860 - 863
Main Authors Iizuka, M., Igarashi, K., Chiba, M., Kodama, K., Tsurui, N., Horie, Y., Masamune, O., Arakawa, H.
Format Journal Article
LanguageEnglish
Japanese
Published The Japan Society of Coloproctology 1988
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ISSN0047-1801
1882-9619
1882-9619
DOI10.3862/jcoloproctology.41.860

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Abstract The occurrence of Clostridium dificile toxin in feces was studied in 17 cases of ulcerative colitis (mild, 5 ; moderate, 11 ; severe, 1) (initial attack, 1 ; relapsing-remitting, 15 ; chronic persistent, 1). Toxin was demonstrated in only two of the 17 cases (11.8%). In one of these two cases, antibiotics had been administered beforehand and the diagnosis made was ulcerative colitis with antibiotic-associated pseudomembranous colitis. In the other case, toxin was positive only on admission and became negative three days later without treatment. There was no correlation between the presence of the toxin and the severity of ulectative colitis. Since toxin was negative in all of 11 cases treated with sulfasalazine, administration of this agent was unrelated to the presence of the toxin. Our results suggest that Clostridium difficite toxin is not related to the onset or relapse of ulcerative colitis.
AbstractList The occurrence of Clostridium dificile toxin in feces was studied in 17 cases of ulcerative colitis (mild, 5 ; moderate, 11 ; severe, 1) (initial attack, 1 ; relapsing-remitting, 15 ; chronic persistent, 1). Toxin was demonstrated in only two of the 17 cases (11.8%). In one of these two cases, antibiotics had been administered beforehand and the diagnosis made was ulcerative colitis with antibiotic-associated pseudomembranous colitis. In the other case, toxin was positive only on admission and became negative three days later without treatment. There was no correlation between the presence of the toxin and the severity of ulectative colitis. Since toxin was negative in all of 11 cases treated with sulfasalazine, administration of this agent was unrelated to the presence of the toxin. Our results suggest that Clostridium difficite toxin is not related to the onset or relapse of ulcerative colitis.
Author Arakawa, H.
Masamune, O.
Kodama, K.
Igarashi, K.
Horie, Y.
Iizuka, M.
Tsurui, N.
Chiba, M.
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References 10) Keighley MRB, Young D, Johnson M, et al : Clostridium difficle toxin in acute dirrhoea complicating inflammatory bowel disease. Gut 23 : 410-414, 1982
16) Truelove SC, Witts IJ : Cortisone in ulcerative colitis. Report on therapeutic trial. Br Med J 2, 375, 1953
19) Hall IC, O'Toole E : Intestinal flora in new-born infants with a description of a new pathogenic anaerobe Bacillus difficile.Am J Dis Child 49 : 309-402, 1935
21) Banno Y, Kobayashi T, Kono H, et al : Biochemical characterization and biologic action of two toxins (D-1 and D-2) from Clostridium difficle. Rev Infect Dis 6 : S11-S20, 1984
5) Trnka YM, Lamont JT : Association of clostridium difficile toxin with symptomatic relapse of chronic inflammatory bowel disease. Gastroenterology 80 : 693-696, 1981
6) Bolton RP, Sherriff RJ, Read AE : Clostridium difficile associated diarrhea : a role in inflammatory bowel disease? Lancet I 383-384, 1980
9) Meyers S, Mayer L, Bottone E, et al : Occurrence of Clostridium difficle toxin during the course of inflammatory bowel disease.Gastroenterology 80 : 697-700, 1981
14) 小島孝雄,中村俊之,吉田貴,ほか:糞便からclostridium difficile toxinを検出した潰瘍性大腸炎の一例.日消病会誌78 : 1298-1302, 1981
4) Lamont JT, Trnka YM : Therapeutic implications of Clostridium difficile toxin during relapse of chronic inflammatory bowel disease. Lancet I : 381-383, 1980
13) 福田博英,井出孝,市村経敏ほか:Clostridium difficleを検出した13症例の臨床的検討.日消病会誌80 : 954-962, 1981
2) Bartlett JG, Moon N, Chang TW, et al:Role of clostridium difficile in antibiotic-associated pseudomembranous colitis. Gastro-enterology 75 : 778-782, 1978
20) Sullivian NM, Pellet S, Wilkins TD :Purification and characterization of toxin A and B of Clostridium difficile. Infect Immunity 35 : 1032-1040, 1982
7) Greenfield C, Ramirez JRA, Pounder RE,et al : Clostridium difficile and inflammatory bowel disease. Gut 24 : 713-717, 1983
1) Larson HE, Price AB, Honour P : Clostridium difficile and etiology of pseudomembranous colitis. Lancet I : 1063-1066, 1978
17)古川清憲,山口裕通,足立憲治,ほか;抗生物質におけるClostridium difficle toxinの簡易同定法.最新医38 : 2475-2480, 1983
12) Hyams JS, McLaughlin JC : Lack of relationship between Clostridium difficle toxin and inflammatory bowel disease in children. J Clin Gastroenterol 7 : 387-390, 1985
3) Bartlett JG, Chang TW, Gurwith M, et al : Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 298 : 531-534, 1978
11) Rolny P, Järnerot G, Möllby R : Occurrence of Clostridium difficle toxin in inflammatory bowel disease. Scand J Gastroenterol 18 : 61-64, 1983
18)稲松孝思:Clostridium difficleの毒素迅速同定.目医師会誌96 : 1896-1897, 1986
8) Lee DKF, Cooper BT, Barbezat GO, et al : Clostridium difficle toxin in chronic idiopathic colitis. NZ Med J 99 : 620-622, 1986
15) 千葉満郎,長沼敏雄,後藤充男,ほか:抗生物質投与後偽膜性大腸炎を合併した潰瘍性大腸炎の1例―Basedow病の合併についての考察も含めて―.Gastroenterol Endosc 27 : 2797-2805, 1985
References_xml – reference: 15) 千葉満郎,長沼敏雄,後藤充男,ほか:抗生物質投与後偽膜性大腸炎を合併した潰瘍性大腸炎の1例―Basedow病の合併についての考察も含めて―.Gastroenterol Endosc 27 : 2797-2805, 1985
– reference: 8) Lee DKF, Cooper BT, Barbezat GO, et al : Clostridium difficle toxin in chronic idiopathic colitis. NZ Med J 99 : 620-622, 1986
– reference: 20) Sullivian NM, Pellet S, Wilkins TD :Purification and characterization of toxin A and B of Clostridium difficile. Infect Immunity 35 : 1032-1040, 1982
– reference: 7) Greenfield C, Ramirez JRA, Pounder RE,et al : Clostridium difficile and inflammatory bowel disease. Gut 24 : 713-717, 1983
– reference: 19) Hall IC, O'Toole E : Intestinal flora in new-born infants with a description of a new pathogenic anaerobe Bacillus difficile.Am J Dis Child 49 : 309-402, 1935
– reference: 14) 小島孝雄,中村俊之,吉田貴,ほか:糞便からclostridium difficile toxinを検出した潰瘍性大腸炎の一例.日消病会誌78 : 1298-1302, 1981
– reference: 5) Trnka YM, Lamont JT : Association of clostridium difficile toxin with symptomatic relapse of chronic inflammatory bowel disease. Gastroenterology 80 : 693-696, 1981
– reference: 12) Hyams JS, McLaughlin JC : Lack of relationship between Clostridium difficle toxin and inflammatory bowel disease in children. J Clin Gastroenterol 7 : 387-390, 1985
– reference: 4) Lamont JT, Trnka YM : Therapeutic implications of Clostridium difficile toxin during relapse of chronic inflammatory bowel disease. Lancet I : 381-383, 1980
– reference: 16) Truelove SC, Witts IJ : Cortisone in ulcerative colitis. Report on therapeutic trial. Br Med J 2, 375, 1953
– reference: 17)古川清憲,山口裕通,足立憲治,ほか;抗生物質におけるClostridium difficle toxinの簡易同定法.最新医38 : 2475-2480, 1983
– reference: 11) Rolny P, Järnerot G, Möllby R : Occurrence of Clostridium difficle toxin in inflammatory bowel disease. Scand J Gastroenterol 18 : 61-64, 1983
– reference: 21) Banno Y, Kobayashi T, Kono H, et al : Biochemical characterization and biologic action of two toxins (D-1 and D-2) from Clostridium difficle. Rev Infect Dis 6 : S11-S20, 1984
– reference: 3) Bartlett JG, Chang TW, Gurwith M, et al : Antibiotic-associated pseudomembranous colitis due to toxin-producing clostridia. N Engl J Med 298 : 531-534, 1978
– reference: 10) Keighley MRB, Young D, Johnson M, et al : Clostridium difficle toxin in acute dirrhoea complicating inflammatory bowel disease. Gut 23 : 410-414, 1982
– reference: 6) Bolton RP, Sherriff RJ, Read AE : Clostridium difficile associated diarrhea : a role in inflammatory bowel disease? Lancet I 383-384, 1980
– reference: 13) 福田博英,井出孝,市村経敏ほか:Clostridium difficleを検出した13症例の臨床的検討.日消病会誌80 : 954-962, 1981
– reference: 18)稲松孝思:Clostridium difficleの毒素迅速同定.目医師会誌96 : 1896-1897, 1986
– reference: 1) Larson HE, Price AB, Honour P : Clostridium difficile and etiology of pseudomembranous colitis. Lancet I : 1063-1066, 1978
– reference: 2) Bartlett JG, Moon N, Chang TW, et al:Role of clostridium difficile in antibiotic-associated pseudomembranous colitis. Gastro-enterology 75 : 778-782, 1978
– reference: 9) Meyers S, Mayer L, Bottone E, et al : Occurrence of Clostridium difficle toxin during the course of inflammatory bowel disease.Gastroenterology 80 : 697-700, 1981
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