Clostridium difficile infection in patients with inflammatory bowel disease: risk factors

Abstract

Introduction. Recent epidemiologic studies have shown that patients with inflammatory bowel disease (IBD), ulcerative colitis (UC) or Crohn’s disease (CD) are at increased susceptibility Clostridium difficile infection (CDI) compared with the general population. The objectives of this study were to assess the incidence and risk factors for CDI in UC patients in a tertiary center from North-Eastern Romania. Material & Methods. Data of all UC and CD patients admitted at the Institute of Gastroenterology and Hepathology, Iasi, Romania between January 2014 and December 2014 were analyzed. In patients with concomitant CDI, risk factors for CDI were identified. Results. A total of 56 UC and 45 CD patients were included in this study, among whom 7 with UC and 5 with CD were identified as having a concomitant CDI. The incidence of CDI in UC patients was 12.5 %, and 11.1% in CD patients. Most of the patients with UC included in the study were men (78.5%) and had active left side colitis. On univariate analysis, age > 60 years (OR = 2.76; CI=1.45- 29.6, p = 0.023) and hemoglobin < 10 mg/dl (OR = 1.93; CI=1.19-18.5, p = 0.043;) were Associatedwith CDI and UC. Most of the patients with CDI and CD were older and had an active colonic form, anemia and increased level of leucocytes. Conclusion. CDI was detected in one of fourth patients admitted with a UC or CD flare. Older age and anemia could represent risk factors of CDI in patients with inflammatory bowel disease.