Isolation of Clostridium difficile from patients with inactive Crohn's disease

Based upon studies of patients with inflammatory bowel disease, Clostridium difficile and an associated cytotoxin have been proposed as contributory factors in relapse of disease. These studies have not included a comprehensive search for other bacterial pathogens. Fifty patients with Crohn's disease were investigated to determine if selected enteric pathogens colonize the bowel and if they play a role in the activity of the disease. Clostridium difficile was recovered from 8% of patients, all with inactive disease, and recovery of the organism did not presage relapse. Except for Salmonella species in one asymptomatic patient, no other bacterial pathogens were isolated. It was concluded that Clostridium difficile may be part of the bowel flora of patients with Crohn's disease without relationship to activity of disease.