IBD Activity May Increase Risk for Clostridioides Difficile Infection

WEDNESDAY, March 5, 2025 (HealthDay News) — For patients with inflammatory bowel disease (IBD), risk factors associated with Clostridioides difficile infection (CDI) include recent diagnosis, corticosteroid usage, and hospitalization, according to a study published online Feb. 17 in Therapeutic Advances in Gastroenterology.

Krista Vitikainen, from Helsinki University Hospital, and colleagues conducted a case-control cohort study of patients with IBD with and without CDI episodes to examine clinical risk factors for CDI and its recurrence. The study included 279 patients with IBD and CDI. Medical history and IBD-related symptoms three months preceding a toxin-positive CDI were recorded and compared to patients with IBD who did not have CDI (matched for sex and age).

The researchers found that IBD was active before CDI based on clinical symptoms and fecal calprotectin levels. The risk for CDI was increased with recently diagnosed IBD. CDI episodes were frequently preceded by corticosteroid usage (64 percent). There was no association seen for advanced therapies with CDI. In 30 percent of the episodes, antibiotic intake was not registered before CDI. Thirty percent of the patients with IBD and CDI were hospitalized before the primary CDI. Recurrent CDI occurred in 30 percent of patients with IBD and CDI; two-thirds of these episodes were registered within 90 days of the previous episode. Overall, 79 percent of patients with recurrent CDI had ulcerative colitis.

“The prior use of corticosteroids, hospitalization, and the presence of gastrointestinal symptoms before CDI likely indicate an underlying IBD flare, suggesting that inadequate disease control may contribute to the risk of CDI,” the authors write.

Several authors disclosed ties to the pharmaceutical industry.

Abstract/Full Text