Evidence map›Paper›PMID 39923011›Full record

ArticleBMC gastroenterology2025

Risk factors for Clostridioides difficile infection among patients diagnosed with inflammatory intestinal and rheumatological diseases in the biologic era.

Helena Martínez-Lozano, Paula Saralegui-Gonzalez, Elena Reigadas, Pablo Ramón Fueyo-Peláez, Aurea García-García, José Miranda-Bautista, Luis Alcalá, Juan Carlos Nieto, María Elena Lobato-Matilla, Ignacio Marín-Jiménez and 2 more

Abstract read
In one paragraph

Article in BMC gastroenterology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Review
  2. Comparative risk ofTherapeutic advances in gastroenterology · 2026
    Article
  3. Biomedicines · 2025
    Review
  4. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

12 authors.

Helena Martínez-LozanoDepartment of Digestive System Medicine, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/ Dr. Esquerdo 46, Madrid, 28007, Spain.
Paula Saralegui-GonzalezDepartment of Digestive System Medicine, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/ Dr. Esquerdo 46, Madrid, 28007, Spain.
Elena ReigadasDepartment of Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Pablo Ramón Fueyo-PeláezDepartment of Digestive System Medicine, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/ Dr. Esquerdo 46, Madrid, 28007, Spain.
Aurea García-GarcíaDepartment of Digestive System Medicine, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/ Dr. Esquerdo 46, Madrid, 28007, Spain.
José Miranda-BautistaDepartment of Digestive System Medicine, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/ Dr. Esquerdo 46, Madrid, 28007, Spain.
Luis AlcaláDepartment of Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Juan Carlos NietoDepartment of Rheumatology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
María Elena Lobato-MatillaDepartment of Pharmacy Hospital General, Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), Madrid, Spain.
Ignacio Marín-JiménezDepartment of Digestive System Medicine, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/ Dr. Esquerdo 46, Madrid, 28007, Spain.
Patricia MuñozDepartment of Microbiology, Hospital General Universitario Gregorio Marañón, Madrid, Spain.
Luis MenchénDepartment of Digestive System Medicine, Hospital General Universitario Gregorio Marañón - Instituto de Investigación Sanitaria Gregorio Marañón (IiSGM), C/ Dr. Esquerdo 46, Madrid, 28007, Spain. lamenchen.hgugm@salud.madrid.org.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundClostridioides difficile infection (CDI) in inflammatory bowel disease (IBD) has been associated with poor clinical outcomes. The relationship between biologic therapy and CDI is controversial. We aimed to assess whether biologic therapy increases CDI risk among IBD patients, to identify factors associated with increased CDI risk, and to characterize CDI episodes in our population.

methodsWe included patients diagnosed with IBD (IBD-cohort) and immune-mediated inflammatory rheumatic diseases (Rheuma-cohort). Risk factors for CDI were assessed using a logistic regression model. We also estimated the incidence rate of CDI for each biologic.

resultsWe included 1866 patients: 1041 from the IBD-cohort and 825 from the Rheuma-cohort. The diagnosis of IBD was the major risk factor for developing CDI in the overall population (OR: 18.29, CI 95%: 5.59-59.80, p < 0.001). Within the IBD-cohort, patients with ulcerative colitis had an increased risk for CDI compared to Crohn's disease (OR:2.00, 95% CI: 1.18-3.42, p = 0.011). Although the subgroup of IBD patients receiving biologics showed a higher incidence of CDI compared to unexposed IBD patients, biologic therapy was not an independent risk factor for CDI in the logistic regression model; nevertheless, patients who received 3 or more biologic agents had a significantly higher risk for CDI (OR: 3.09, CI 95% 1.13-8.47, p = 0.028).

conclusionsIBD significantly increases the risk of CDI among patients treated with biologic therapy; although such treatments do not seem to individually increase the risk, the number of biologics received may be a new predictor of CDI.

Indexed as

Biological ProductsClostridium InfectionsCrohn DiseaseInflammatory Bowel DiseasesRheumatic DiseasesAdultAgedClostridioides difficileCohort StudiesColitis, UlcerativeFemaleHumansIncidenceLogistic ModelsMaleMiddle AgedBiological ProductsBiologicsClostridioides difficileImmune-mediated inflammatory diseasesInflammatory bowel disease

Identifiers

PMID39923011
PMCPMC11806733

What OpenQuestion holds

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LicenceCC BY-NC-ND
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Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.