Clostridium difficile is an increasingly prevalent hospital-acquired infection that affects patients with cirrhosis. A study of over 80,000 patients with cirrhosis found patients with C. difficile-associated disease to have higher mortality and longer length of stay in higher care units than those without infection.2 Antibiotics and proton pump inhibitors were independently associated with C. difficile infection. Thus …show more content…
group I) (p<0.0001).2
Patients with cirrhosis may be at particular risk of developing Clostridium difficile infection, for three reasons:
First, antibiotic use in cirrhosis is common.13
Second, cirrhotics also commonly receive PPI, both for established indications such as symptomatic gastro-esophageal reflux, prior peptic ulcer disease as well as for unproven indications such as healing of esophageal ulcers after endoscopic band ligation 14 and these drugs have been associated with enteric infections, namely Clostridium difficile infection.15
Third, frequent need for hospitalization to treat complications of cirrhosis, such as variceal bleeding, ascites or encephalopathy, places patients in an environment in which there is high likelihood of exposure to Clostridium difficile infection.16
The most striking point in the results of this study is the noted effect of bilharziasis on the rate of clostridium difficile infection in hospitalized cirrhotic patients in the NLI hospital and the positive impact of bilharzial infection on clostridium difficile infection in our study, it may be attributed