Molecular typing and clinical characteristics of Clostridioides difficile infection in patients with inflammatory bowel disease: a retrospective study.

Objective: The increasing incidence of Clostridioides difficile infection (CDI) has been associated with poorer prognosis of patients with inflammatory bowel disease (IBD). However, relevant data are limited in China. The aim of this study was to clarify the molecular types and clinical characteristics of C. difficile in IBD patients in China.

Methods: Stool samples were collected, cultured anaerobically, and tested for glutamate dehydrogenase and C. difficile toxins A and B. Toxigenic C. difficile isolates were subjected to multilocus sequence typing and antimicrobial susceptibility testing. Clinical data were collected to compare IBD and non-IBD patients with CDI, and to determine the risk factors associated with CDI in IBD patients.

Results: The incidence of CDI was significantly higher in IBD patients than non-IBD patients (27.2% vs. 9.0%, respectively). Among IBD patients, the dominant sequence types (STs) were ST54 (20.2%), ST2 (14.9%), ST3 (14.9%), and ST42 (13.2%). The STs with the highest multidrug resistance rates were ST37 (100%), ST35 (100%), and ST42 (73.3%). In IBD patients, hospitalization within 6 months and use of 5-aminosalicylic acid were independent risk factors for CDI. Other risk factors included the use of proton pump inhibitors, immunosuppressants, and corticosteroids.

Conclusions: The incidence of CDI was significantly higher in IBD patients than non-IBD patients. Surveillance of CDI in hospitalized patients should be strengthened to reduce the incidence of CDI in IBD patients.