P452 Fecal Microbiota Transplantation Leads to Lower IBD Related Complications in Hospitalized Inflammatory Bowel Disease Patients with Clostridioides difficile Infection: A retrospective cohort study

Abstract

Abstract Background Clostridioides difficile (C. difficile) infection (CDI) increases the risks of hospitalization, colectomy, and mortality in inflammatory bowel disease (IBD). There has been no study comprehensively evaluating the risk factors, clinical characteristics, and outcomes of CDI in IBD. Methods In this retrospective cohort study, we enrolled hospitalized IBD patients with toxin A/B results for C. difficile in a medical center between April 2007 and April 2021. They were divided into CDI group and control groups. The risk factors, clinical presentations and outcomes were analyzed. Results A total of 144 IBD inpatients (45 CDI group and 99 control group) were enrolled for analysis. The median follow-up duration was 15.5 months. The incidence of CDI in IBD inpatients was 31%. The risk factors of CDI included longer IBD duration, biological failure, and biological user. More patients presented as abdominal pain in CDI group (77.8% vs 55.6%, P=0.011). After antibiotics treatment and fecal microbiota transplantation, 83.3% patients had negative result, and 61.9% had improved clinical symptoms. Regarding clinical outcomes, CDI led to more hospitalizations (median 2 times (range 0-12 times) vs median 1 time (range 0-19 times), P=0.008), lower steroid free remission rate (46.7% vs 67.7%, P=0.017) and higher Mayo score (median 5 points (range 2-12 points) vs median 3 points (range 0-12 points)). Compared to antibiotics treatment, the patients receiving fecal microbiota transplantation (FMT) had less times of hospitalization and less IBD related complications during follow-up. Conclusion CDI led to more hospitalizations, lower steroid free remission rate and higher Mayo score in IBD inpatients. FMT should be considered in refractory or recurrent CDI in IBD to improve the clinical outcomes.