Clostridium difficile toxin assay in psoriatic patients

Area of Science:

• Gastroenterology
• Dermatology
• Infectious Diseases

Background:

• Chemotherapy-induced pseudomembranous colitis is linked to methotrexate and 5-fluorouracil.
• Methotrexate and mesalazine are used for psoriasis, but their impact on Clostridium difficile carriage is unknown.

Purpose of the Study:

• To detect Clostridium difficile toxin in psoriasis patients undergoing systemic therapy.
• To investigate the effect of methotrexate and mesalazine on C. difficile carriage in psoriatic patients.

Main Methods:

• 58 psoriasis patients were divided into groups based on disease severity and treatment (methotrexate, mesalazine).
• Stool samples were analyzed for C. difficile toxin using the latex agglutination method.
• Patients receiving methotrexate or mesalazine had samples taken after at least 4 weeks of therapy.

Main Results:

• 19 out of 58 patients tested positive for C. difficile toxin.
• A higher rate of C. difficile carriage was observed in patients on methotrexate and mesalazine.
• Most toxin-positive patients were asymptomatic, with only three reporting mild gastrointestinal symptoms.

Conclusions:

• Methotrexate and mesalazine therapy may increase Clostridium difficile gastrointestinal carriage in psoriasis patients.
• The presence of C. difficile toxin did not strongly correlate with gastrointestinal symptoms in this cohort.
• Further research is needed to understand the clinical significance of C. difficile carriage in psoriatic patients on these therapies.