Clostridium difficile-associated disease rates have been increasing.
Dr Joseph Rodemann and colleagues from Missouri determined whether C difficile-associated disease incidence has increased in hospitalized patients with inflammatory bowel disease (IBD).
The team also explored possible differences in the risk for and time to presentation of C difficile-associated disease between IBD and non-IBD patients.
|Time from admission to a positive C difficile test for Crohn's was under a day|
|Clinical Gastroenterology & Hepatology|
The research team analyzed hospital admissions from 1998 to 2004 for demographics, length of stay, C difficile infections.
The research team also analyzed time from admission to a positive C difficile test.
The team calculated C difficile-associated disease incidence for non-IBD, IBD, Crohn's-disease, and ulcerative colitis admissions.
The researchers used logistic regression to estimate the risk for C difficile-associated disease.
The team found C difficile-associated disease incidence increased in each group.
The incidence of C difficile was higher in all groups with IBD than non-IBD groups.
During the observation period, C difficile-associated disease rates approximately doubled in Crohn-disease, and tripled in ulcerative colitis.
The researchers observed that length of stay was similar among the groups.
For all years combined, the adjusted odds ratio for C difficile-associated disease in all IBD admissions was 3.
The team noted that the adjusted odds ratio for C difficile-associated disease in Crohn‘s-disease admissions was 2.
The adjusted odds ratio for C difficile-associated disease for ulcerative colitis admissions was 4.
The median times from admission to a positive C difficile test result for non-IBD, and Crohn's disease were 4 days, and less than 1 day, respectively.
The team found that the median time from admission to a positive C difficile test result for ulcerative colitis was half a day.
Dr Rodemann's team commented, “C difficile-associated disease incidence in IBD has increased, and is higher than in the non-IBD population.”
“IBD and ulcerative colitis patients in particular have a higher risk for C difficile-associated disease.”
“C difficile infections in IBD are confirmed predominantly within 48 hours of admission, suggesting most were acquired before hospitalization.”