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Differentiating Clostridium difficile Colitis from Clostridium difficile Colonization in Ulcerative Colitis: A Role
Andrew R Reinink1, Julajak Limsrivilai, Bethany A Reutemann
1Minneapolis Veterans Affairs Medical Center and University of Minnesota, Minneapolis, MN, USA.
Digestion
|October 17, 2017
Summary
Procalcitonin (PCT) levels did not reliably distinguish Clostridium difficile infection (CDI) from ulcerative colitis (UC) flares. However, PCT was higher in patients who responded to CDI treatment versus those with UC flare, suggesting a potential diagnostic role.
Area of Science:
- Gastroenterology
- Infectious Diseases
- Clinical Biomarkers
Background:
- Clostridium difficile infection (CDI) is a common complication in ulcerative colitis (UC) patients, often mimicking a disease flare.
- Differentiating between CDI and UC flare is clinically challenging, especially with C. difficile colonization.
- Procalcitonin (PCT) is a serum biomarker investigated for bacterial infections.
Purpose of the Study:
- To evaluate the utility of serum procalcitonin (PCT) in differentiating acute Clostridium difficile infection (CDI) from ulcerative colitis (UC) flare.
- To assess if PCT levels can distinguish between CDI and C. difficile colonization in UC patients.
Main Methods:
- A single-center prospective cohort study.
- Enrolled 117 ulcerative colitis patients undergoing C. difficile testing between 2013 and 2016.
- Collected data through chart review.
Main Results:
- Serum PCT levels were not significantly different between UC patients with CDI (median 60.7 pg/mL) and those without CDI (median 56.7 pg/mL).
- Among CDI patients, those who responded to treatment (CDI-R) had a significantly higher median PCT (104.5 pg/mL) compared to those who did not respond and were diagnosed with UC flare (CDI-NR, median 40.3 pg/mL).
Conclusions:
- Serum PCT did not effectively differentiate CDI from UC flare or colonization in UC patients presenting with diarrhea.
- Elevated PCT levels in CDI-responders compared to non-responders suggest PCT may aid in discriminating between CDI and UC flare in specific contexts.