Abstract
BACKGROUND: The prospective assessment of Clostridium difficile infection (CDI) impact in inflammatory bowel disease (IBD) patients with colitis flare in outpatient setting has far been poorly investigated. We aimed to explore the prevalence and factors associated with CDI in IBD outpatients presenting with colitis flares as well as the outcomes following treatment. METHODS: In this prospective cohort study, conducted between October, 2013 and July, 2016, 120 IBD patients (55% presenting a colitis flare) and 40 non-IBD controls were assessed for CDI. Multivariate regression was performed to identify predictors of CDI. Outcome analysis was accomplished for recurrent CDI, hospitalization, colectomy, and CDI-associated mortality. RESULTS: The proportion of patients with CDI was significantly higher in IBD patients experiencing flares than in both inactive IBD and non-IBD groups (28.8% vs. 5.6% vs. 0%, respectively; P=0.001). Females (OR=1.39, 95% CI, 1.13-17.18), younger age (OR=0.77, 95% CI, 0.65-0.92), steroids treatment (OR=7.42, 95% CI, 5.17-40.20), and infliximab therapy (OR=2.97, 95% CI, 1.99-24.63) were independently associated with CDI. There was a dose-related increase in the odds of having CDI on patients using prednisone. All patients treated with vancomycin had a satisfactory response to therapy, but 21% presented recurrent CDI and 16% were hospitalized. Neither colectomy nor mortality was noticed. CONCLUSION(S): In IBD outpatients presenting with colitis flares, CDI is highly prevalent. Females, younger age, infliximab use, and notably steroids therapy were independently associated with CDI. Most patients with CDI experienced mild-to-moderate disease and prompt treatment with vancomycin was highly effective, what seems to reduce the serious complications risks.
Published Version
Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a call