PTH-080 Clostridium difficile infection in pre-existing inflammatory bowel disease: a case series
Abstract
Introduction Inflammatory bowel disease (IBD) is a risk factor for clostridium difficile infection (CDI), and It is known that CDI in an IBD patient is associated with higher morbidity and mortality. It is thought that factors including alterations in the gut microbiome, mucosal disruption and immunosuppression provide a synergistic environment for CDI to complicate an IBD flare, yet there is no agreed consensus on best management of these patients. Our aim is to examine a series of recent cases to assess our own practice and subsequent outcomes. Methods A retrospective analysis was carried out of all cases of CDI in IBD patients in NHS GG&C during 2018. Patients were identified via the regional CDI database; those with co-existing IBD were extrapolated. Data collected included demographics, IBD subtype, and presence of other CDI risk factors. Severity of symptoms was assessed using Truelove & Witts Criteria. Initial management, and any changes following the diagnosis of CDI were noted. Outcomes were measured by length of stay, survival to discharge and whether surgical intervention was required. Results 14 patients in total were identified. 10 had a diagnosis of ulcerative colitis, 3 of Crohn’s disease and 1 IBD unclassified. 11 of the 14 were on immunosuppressive therapy at the time of CDI (2 anti TNF; 1 thiopurine; 1 steroid; 7 5ASA) – this was continued in all cases. 9 of the patients presented with acute severe colitis based on Truelove & Witts Criteria. Once the…
How strong is the evidence?
Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health. Reported size: 14 participants or records.
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