Clinical and Endoscopic Features of Pseudomembranous Colonitis:An Analysis of 68 Cases

OBJECTIVE:To analyze the clinical and endoscopic features of pseudomembranous colonitis(PMC),and facilitate clinicians understanding on this disease.METHODS:A total of 68 patients with pseudomembranous colonitis were assigned to two groups according to age difference,and the clinical data of the two groups were analyzed retrospectively.RESULTS:There were 47 cases(69.12%) in older age-group versus 21 cases(30.88%) of the middle-aged group.In the older age group,20(42.55%) were critical cases and 43(91.49%) had serious chronic underlying diseases,both were significantly higher than in the middle-aged group(P 0.025).Clindamycin was the chief antibiotics that lead topseudomembranous enteritis,followed by the third generation cephalosporins,quinolones,the second generation cephalospoins and betalactams,and the differences between the two groups were nonsignificant(all P 0.05).Anaerobic culture of focus nidus performed under electronic colonoscope revealed a significantly higher positive rate than did the anaerobic culture of stools [82.5%(33 /40) vs.5.88%(4 /68),P 0.05].On withdrawal or replacing antibiotics with metronidazole /ornidazole,vancomycinornidazoleand intestinal probiotics,64 cases(94.12%) had cures,3 cases(4.41%) had improvement,and 1 case(1.47%) died.CONCLUSION:(1) PMC is a serious condition of the antibiotic-associated colitis;(2) older age,lower immune function,associated serious chronic disease are high risk factors of PMC;(3) Endoscopy is the most effective method for diagnosing PMC;(4) The possibility of clostridium difficile enterocolitis should be considered if patients present with severe diarrheas during antibiotic treatment.