Risk factors and clinical outcome of Clostridium difficile infection in patients with IBD : A single‐center retrospective study of 260 cases in C hina

OBJECTIVE Clostridium difficile infection ( CDI ) may lead to poor outcomes in patients with inflammatory bowel disease ( IBD ). In this study we aimed to investigate the cumulative incidence, risk factors and outcome of CDI in patients with IBD in a single center in C hina. METHODS The clinical features and endoscopic profiles of consecutive IBD patients admitted to R uijin H ospital, S hanghai J iaotong U niversity S chool of M edicine between J anuary 2013 and D ecember 2015 were retrospectively analyzed. CDI was diagnosed based on a positive polymerase chain reaction ( PCR ) stool test. RESULTS A total of 260 patients with IBD were enrolled, including 176 with C rohn’s disease ( CD ) and 84 with ulcerative colitis ( UC ). Altogether 13 (5.0%) patients were diagnosed with CDI . The incidence of CDI was 4.0% (7/176) in CD and 7.1% (6/84) in UC , respectively. The endoscopic feature of pseudomembrane was found in four (33.3%) IBD – CDI patients, and pseudomembrane and deep ulcers were significantly correlated with CDI ( P   <  0.001 and P  = 0.006, respectively). Hemoglobin (Hb) <100 g/L was found to be associated with CDI ( OR 3.48, 95% CI 1.04–11.61, P  = 0.043). Patients in the CDI group showed a higher risk of developing abdominal abscesses than those in the non‐ CDI group ( OR 6.09, 95% CI 1.8–15.2, P  = 0.003). CONCLUSIONS PCR ‐based fecal test for CDI should be performed in these IBD patients. Hb <100 g/L may be an important risk factor for CDI in IBD . For patients with CDI , antibiotics should be administered promptly to prevent abdominal abscess.