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Clostridium difficile infection in Polish pediatric outpatients with inflammatory bowel disease

D Wultańska1, A Banaszkiewicz, A Radzikowski

  • 1Department of Medical Microbiology, Medical University of Warsaw, Warsaw, Poland.

European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology
|June 26, 2010
PubMed

Insights

Clostridium difficile infection (CDI) is common in pediatric inflammatory bowel disease (IBD) outpatients, affecting 60% of patients. Recurrences were seen in 17%, independent of IBD type or therapy.

Area of Science:

  • Gastroenterology
  • Infectious Diseases
  • Pediatrics

Background:

  • Clostridium difficile infection (CDI) prevalence in pediatric inflammatory bowel disease (IBD) is underrecognized.
  • IBD patients are at increased risk for CDI and its complications.

Purpose of the Study:

  • To assess CDI prevalence and recurrence rates in pediatric IBD outpatients.
  • To evaluate the influence of IBD therapy on CDI.
  • To determine antimicrobial susceptibility of C. difficile strains.

Main Methods:

  • Prospective, single-center observational study.
  • Screening of fecal samples for C. difficile and toxins.
  • PCR ribotyping for C. difficile genotyping.
  • Diagnosis and severity assessment using established criteria (Porto, Hyams, Truelove-Witts scales).

Main Results:

  • 60% of pediatric IBD outpatients had CDI, irrespective of disease type (Crohn's disease or ulcerative colitis).
  • 17% of patients experienced CDI recurrence.
  • All C. difficile strains were susceptible to metronidazole, vancomycin, and rifampin.
  • No significant correlation found between CDI and IBD therapy.

Conclusions:

  • High prevalence of CDI and recurrences in pediatric IBD outpatients.
  • CDI risk is independent of IBD type or current therapy.
  • PCR ribotyping indicated reinfection and relapses during IBD episodes.

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