Clostridium Difficile Infection in Inflammatory Bowel Disease; Does it Have an Impact?

Sabet, Tarek; Elbanna, Amany; Bedewy, Essam El-Din; Abozamel, Mohamed; Abdel Salam, Shwikar; Shamsya, Ayman

doi:10.21608/aeji.2020.29513.1077

Clostridium Difficile Infection in Inflammatory Bowel Disease; Does it Have an Impact?

Document Type : Original Article

Authors

¹ Department of Internal Medicine, Faculty of Medicine, University of Alexandria, Egypt.

² Department of Tropical Medicine & amp; Hygiene, Faculty of Medicine, University Of Alexandria ,Egypt.

³ Specialist of Internal Medicine, Alexandria University Students' Hospital,Egypt.

⁴ Department of Medical Microbiology & Immunology, Faculty of Medicine, University of Alexandria, Egypt.

10.21608/aeji.2020.29513.1077

Abstract

Background and study aim: Limited data exist on outcomes in inflammatory bowel disease (IBD) patients who develop Clostridium Difficile infection (CDI). The aim of the study to investigate prevalence of CDI in IBD with assessment of the disease behavior in affected patients.
Patients and Methods: 30 IBD patients and 15 healthy subjects of matched age & sex as control group. Patient were classified into two groups; group I (15 patients with Crohn’s disease), group II (15 patients with ulcerative colitis) & control group (15 Patients not having IBD). Disease activity for group I was determined by Crohn's disease activity index (CDAI) & for group II by Truelove & Witts score. All patients & controls underwent Computed Tomography Enterocolongraphy, ileo-colonoscopy with ileal & colonic biopsies, and Clostridium Difficile detection & quantification plus detection of toxin A & B using SYBR Green Real-time PCR.
Results: 3 patients from group I had CDI and these 3 patients had active disease, one with severe activity (CDAI 550) and two with moderate activity (CDAI 380 & 420). Also 3 patients from group II had CDl and these 3 patients had moderate activity. Only one patient from the control group had CDI carriage (non-toxin producing strain).The rest of patients (38 patients) had no CDI (of them, one patient had mildly active Crohn's disease with CDAI of 200 & two patients had mildly active ulcerative colitis & the others were in remission).
Conclusion: Prevalence of toxigenic CDI was 20% among IBD patients and significantly associated with disease activity.

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