Clostridium difficile in Inflammatory Bowel Disease: A Retrospective Study

Abstract EN

Aim.

To investigate the epidemiology and risk factors of Clostridium difficile infections (CDI) in patients with inflammatory bowel disease (IBD).

Methods.

This is a retrospective study of patients diagnosed with IBD.

1006 charts were screened and 654 patients met the inclusion criteria.

Patients were divided into 2 cohorts based on the presence of prior diagnosis of CDI.

Statistical analysis with Pearson’s chi-squared and two-sample t-test was performed.

Results.

The incidence of CDI among IBD patients was 6.7%.

There was equal prevalence of CDI among Crohn’s disease (CD) (n=21, 49%) and ulcerative colitis (UC) (n=22, 51%).

IBD patients acquired CDI at a mean age of 42.7 years, with 56% of infections acquired in the community and only 28% associated with healthcare.

Only 30% of IBD patients with CDI had prior antibiotic use, and 16% had prior steroid use.

IBD patients were significantly more likely to require biologic therapy (57% versus 37%, p<0.01) and have extraintestinal manifestations of IBD (43% versus 28%, p<0.02).

Conclusions.

IBD patients are more susceptible to CDI at a younger age and often lack traditional risk factors.

IBD patients with at least one CDI were more likely to require biologic therapy and had greater rates of extraintestinal manifestations.