Risk Factors for Clostridium difficile Isolation in Inflammatory Bowel Disease: A Prospective Study.

Area of Science:

• Gastroenterology
• Infectious Diseases
• Microbiology

Background:

• Clostridium difficile is a common stool pathogen in patients with inflammatory bowel disease (IBD).
• Traditional risk factors for C. difficile infection may not apply to IBD patients.
• Previous studies have not investigated risk factors for C. difficile isolation in IBD outpatients, including both symptomatic and asymptomatic individuals.

Purpose of the Study:

• To identify risk factors for Clostridium difficile isolation in inflammatory bowel disease (IBD) outpatients.
• To assess the association between C. difficile isolation and subsequent disease relapse in IBD patients.

Main Methods:

• Prospective recruitment of 190 IBD patients (Crohn's disease and ulcerative colitis) between April 2015 and February 2016.
• Rectal swabs analyzed for toxigenic C. difficile using culture and PCR.
• Data collection on demographics, healthcare exposures, medical therapies, and disease activity.

Main Results:

• Toxigenic C. difficile was isolated in 8.4% of patients.
• In Crohn's disease, a history of C. difficile infection (CDI) and recent emergency department visits were associated with C. difficile isolation.
• In ulcerative colitis, hospitalization in the past 12 months was linked to C. difficile isolation.
• C. difficile isolation was not associated with a higher risk of subsequent disease relapse in either Crohn's disease or ulcerative colitis.

Conclusions:

• Healthcare exposures are significant risk factors for C. difficile isolation in IBD patients.
• The clinical significance of C. difficile isolation in IBD requires further investigation, as it did not predict disease relapse in this study.