ArticleDigestive diseases and sciences2018
Risk Factors for Clostridium difficile Isolation in Inflammatory Bowel Disease: A Prospective Study.
Article in Digestive diseases and sciences, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 8 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
8 citing papers in PubMed, 15 citations in OpenAlex.
- Global Patterns ofCrohn's & colitis 360 · 2025Article
- Prevalence and sequelae of asymptomatic Clostridioides difficile colonization in children with inflammatory bowel disease.Journal of pediatric gastroenterology and nutrition · 2025Article
- Clostridioides difficile toxin is infrequently detected in inflammatory bowel disease and does not associate with clinical outcomes.Gut pathogens · 2022Article
- [The Korean journal of gastroenterology = Taehan Sohwagi Hakhoe chi · 2022Review
- Incidence of Early and Late-OnsetSurgery research and practice · 2022Article
- Diagnosis and management of Clostridioides difficile infection in patients with inflammatory bowel disease.Current opinion in gastroenterology · 2021Review
- Management of Recurrent Clostridioides Infection: A Difficile Problem in Inflammatory Bowel Disease Patients.Digestive diseases and sciences · 2020Article
- Outcomes in patients with inflammatory bowel disease and acute gastrointestinal symptoms who test indeterminate forAnnals of gastroenterologyArticle
Corrections and comments
- Erratum issued
Authors and funding
14 authors at 2 institutions in 1 country.
Funding
Abstract
introductionClostridium difficile is the most commonly isolated stool pathogen in inflammatory bowel disease (IBD). Traditional risk factors for C. difficile may not exist in patients with IBD, and no prior studies have assessed the risk factors for the isolation of C. difficile in both symptomatic and asymptomatic IBD outpatients.
methodsWe prospectively recruited consecutive IBD patients presenting to our outpatient clinic between April 2015 and February 2016. We excluded patients with a diverting ostomy or ileoanal pouch. Demographics, healthcare exposures, medical therapies and disease activity were recorded from medical charts or surveys. A rectal swab was performed from which toxigenic culture and PCR analysis for the presence of toxin and fluorescent PCR ribotyping were performed. The primary outcome of interest was isolation of toxigenic C. difficile.
resultsA total of 190 patients were enrolled in this prospective study including 137 (72%) with Crohn's disease and 53 (28%) with ulcerative colitis. At the time of enrollment, 69 (36%) had clinically active disease. Sixteen (8.4%) patients had toxigenic C. difficile isolated on rectal swab at enrollment and four (2.1%) patients had non-toxigenic C. difficile cultured. Mixed infection with more than one toxigenic isolate was present in 5/16 (31.3%) individuals. Patients with CD with a toxin positive isolate were more likely to have a history of CDI in the past 12 months (40 vs. 11.02%, p = 0.027) and an emergency department visit in the past 12 weeks (50 vs. 20.63%, p = 0.048). In UC, individuals with isolation of C. difficile were more likely to be hospitalized within the past 12 months (66.6 vs. 8.51%, p = 0.003). C. difficile isolation at the time of presentation was not associated with a subsequent disease relapse over a 6-month period in CD (p = 0.557) or UC (p = 0.131).
conclusionHealthcare exposures remain a significant risk factor for C. difficile isolation in the IBD population; however, this was not associated with relapse of disease. Further studies assessing the clinical significance of C. difficile isolation is warranted in IBD.
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