Dr Geoffrey Nguyen and colleagues from Canada determined nationwide, population-based trends in rates of Clostridium difficile infection in hospitalized inflammatory bowel disease patients in the United States.
The research team determined its mortality and economic impact.
|Clostridium difficile was associated with 65% longer lengths of stay with ulcerative colitis|
|American Journal of Gastroenterology|
The team analyzed discharge records from the Nationwide Inpatient Sample.
In addition, the researchers used the International Classification of Diseases, 9th Revision, Clinical Modification codes to identify Crohn's disease, and ulcerative colitis cases.
The team also identified cases of Clostridium difficile infection between 1998 and 2004.
The team compared temporal patterns of Clostridium difficile incidence in inflammatory bowel disease patients to non-inflammatory bowel disease gastroenterology patients and all-hospitalized patients.
The impact of Clostridium difficile on in-hospital mortality and resource utilization was quantified using multiple regression analysis.
The researchers found that the prevalence of Clostridium difficile among ulcerative colitis patients was 37 per 1,000.
The prevalence among Crohn's disease patients was 11 per 1,000.
In patients with non-inflammatory bowel disease gastrointestinal and general medical patients was 5 per 1000.
The team noted that Clostridium difficile incidence nearly doubled among ulcerative colitis patients over 7 years.
After adjustment for confounders, Clostridium difficile infection was associated with greater mortality among patients with ulcerative colitis but not Crohn's disease.
Clostridium difficile was also associated with 65% and 46% longer lengths of stay in patients with ulcerative colitis and Crohn‘s, respectively.
This correlated with 63% and 46% higher average hospital charges, for Crohn's disease and ulcerative colitis patients, respectively.
Dr Nguyen's team concluded, "Clostridium difficile infection is a growing public health issue among hospitalized inflammatory bowel disease patients, especially those with ulcerative colitis,"
"It is associated with higher mortality and resource utilization, prompting the need for better preventative measures and early detection."