Intestinal Research

Infection

The impact of the quality improvement program on Clostridioides difficile infection management: a quasi-experimental study: Jung Yun Lee, Jae-Ki Choi, Tae-Geun Gweon, Young Eun An, Hyo Suk Kim, Jae Hyuck Chang, Tae Ho Kim, Chang Whan Kim, Young-Seok Cho; Intest Res 2025;23(4):551-558. Published online October 28, 2025; DOI: https://doi.org/10.5217/ir.2025.00137

Abstract PDF PubReader ePub: Background/Aims
Clostridioides difficile infection (CDI) is a major cause of nosocomial diarrhea. This study aimed to implement a quality improvement program to expedite proper CDI treatment, including discontinuing laxatives and associated antibiotics.
Methods
Stool test results positive for CDI were automatically sent via text message to the quality improvement team, specialists in CDI management. The quality improvement team played an advisory role in this treatment. The outcome of this study was the competency of CDI treatment within 24 hours of stool test reporting. Competency was investigated using 3 different models: Model 1, initiation of CDI treatment within 24 hours of positive stool test report; Model 2, Model 1 criteria met with no concurrent laxative use; and Model 3, Model 2 criteria met with no concurrent associated antibiotics. Competency rates were compared between pre- and post-intervention periods (1 year each). Analyses were performed for inpatients with CDI.
Results
In total, 310 inpatients with CDI (129 pre-intervention, 181 post-intervention) were included in this study. The rates of competency for Model 1 (85.3% vs. 95.6%, p= 0.006), Model 2 (81.4% vs. 92.3%, p= 0.004), and Model 3 (35.7% vs. 56.4%, p< 0.001) in the post-intervention group were higher to those in the pre-intervention group.
Conclusions
Quality improvement program enhanced the quality of CDI treatment in terms of prompt treatment and discontinuation of concomitant laxatives and associated antibiotics. (cris.nih.go.kr; KCT0005892)

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A Case of Abdominal Actinomycosis Presenting as Ileocecal Ulcers and Recurrent Lower Gastrointestinal Bleeding: Jin Young Park, Sok Won Han, Chang Whan Kim, Tae Ho Kim, Jae Hyuck Chang, Il Ho Maeng, Mi Jeong Lee, Yun Sun Im, Ji Hun Kim, Sung Min Nam; Intest Res 2012;10(3):309-313. Published online July 31, 2012; DOI: https://doi.org/10.5217/ir.2012.10.3.309

Abstract PDF: Abdominal actinomycosis is a rare chronic suppurative infection that is difficult to diagnose precisely without an operation. It also tends to be misdiagnosed as a malignancy, intestinal tuberculosis, diverticular disease, or Crohn's disease. A 54-year-old man presented with loose stools, hematochezia, and vague abdominal pain in the right lower quadrant. He had had a history of hematochezia and recurrent colon ulcers on colonoscopy seven times within the past 3 years. A colonoscopy at admission revealed multiple, variably sized and shaped ulcerations in the terminal ileum, cecum, and ascending and transverse colons. Biopsies from the cecal ulcer demonstrated sulfur granules. This is the first cases of abdominal actinomycosis presenting as a recurrent lower gastrointestinal hemorrhage due to ileocolic ulcerations in Korea. (Intest Res 2012;10: 0-313)

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Endoscopic Differentiation of Small Bowel Strictures: Hwang Choi, Kyu Yong Choi, Bo In Lee, Min Kuk Kim, Hyun Jung Jung, Jeong Seon Ji, Tae Ho Kim, Jung Hwan Oh, Kang Moon Lee, Sang Woo Kim, Soo Heon Park, Hiun Suk Chae, Myung Gyu Choi, Sok Won Han, In Sik Chung; Intest Res 2007;5(1):38-44. Published online June 30, 2007

Abstract PDF: Background/Aims
The diagnosis of small bowel stricture was made by operation. Capsule endoscopy has been useful for diagnosis of small bowel diseases but has limited value in cases with stricture. Double balloon endoscopy is the useful method to visualize the entire small bowel. The aims of this study are to evaluate the feasibility of double balloon endoscopy and to differentiate the endoscopic findings in patients with small bowel stricture. Methods: Between March 2004 and February 2007, fifteen consecutive patients were referred for the evaluation of small bowel stricture. Small bowel strictures were suspected in small bowel series and CT in eleven patients. Capsule endoscopies were performed in six patients and entrapped in three patients. Double balloon endoscopy (EN-450P5/20, Fujinon, Japan) was performed with midazolam (median 5 mg, range 5-10 mg) and meperidine (median 50 mg, range 50-100 mg). All lesions except one were found within 60 minutes. One patient had been excluded because of false-positive finding of capsule endoscopy. Clinical and endoscopic findings were compared between strictures of Crohn's disease (group I, n=6) and those of other causes (group II, n=8). Results: Double balloon endoscpies were performed with good tolerance without side effect. Age, chief complaints, duration of symptom, and initial hemoglobin and serum albumin levels were not different between two groups. The proportion of male sex was higher in group I than group II (100%, 38%, respectively; p=0.031). The strictures below 0.5 cm in diameter were 83% in group I and 13% in group II (p=0.026). The arrangement of stricture in group I was more eccentric than that in group II (100%, 17%, respectively; p=0.015). The location of stricture, appearance of surrounding mucosa, associated ulcer, and ulcer margin were not different between two groups. Conclusions: Endoscopic differentiation using double balloon endoscopy can be made easily and safely in patients with small bowel stricture. The strictures of small bowel in patients with Crohn's disease were narrower and more eccentric than those in patients with other diseases. (Intest Res 2007;5:38-44)

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