Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study
ABSTRACT Clostridioides difficile infection (CDI) worsens the prognosis of patients with inflammatory bowel disease (IBD). This retrospective cohort study aimed to evaluate the risk factors, clinical manifestations, and outcomes of CDI in hospitalized patients with IBD, including those with toxin A/...
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| Format: | Article |
| Language: | English |
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Wiley
2025-05-01
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| Series: | Kaohsiung Journal of Medical Sciences |
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| Online Access: | https://doi.org/10.1002/kjm2.70002 |
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| author | Puo‐Hsien Le Chyi‐Liang Chen Chia‐Jung Kuo Pai‐Jui Yeh Chien‐Chang Chen Yi‐Ching Chen Cheng‐Tang Chiu Hao‐Tsai Cheng Yung‐Kuan Tsou Yu‐Bin Pan Cheng‐Hsun Chiu |
| author_facet | Puo‐Hsien Le Chyi‐Liang Chen Chia‐Jung Kuo Pai‐Jui Yeh Chien‐Chang Chen Yi‐Ching Chen Cheng‐Tang Chiu Hao‐Tsai Cheng Yung‐Kuan Tsou Yu‐Bin Pan Cheng‐Hsun Chiu |
| author_sort | Puo‐Hsien Le |
| collection | DOAJ |
| description | ABSTRACT Clostridioides difficile infection (CDI) worsens the prognosis of patients with inflammatory bowel disease (IBD). This retrospective cohort study aimed to evaluate the risk factors, clinical manifestations, and outcomes of CDI in hospitalized patients with IBD, including those with toxin A/B results between April 2007 and April 2021. Patients were classified into the CDI and control groups. Patients with IBD and recurrent or refractory CDI underwent fecal microbiota transplantation (FMT). A total of 144 inpatients with IBD—45 in the CDI group and 99 in the control group—were analyzed. The incidence of CDI in inpatients with IBD was 31%. The Risk factors for CDI included longer IBD duration, biological therapy failure, and biological use. More patients in the CDI group presented with abdominal pain (77.8% vs. 55.6%, p = 0.011). In the antibiotic treatment‐only group, the symptom improvement rate was 60.7% (17/28), the microbiological cure rate was 89.3% (25/28), and the overall success rate was 71.4% (20/28). After antibiotic treatment and FMT, 71.4% (10/14) of the patients tested negative for CDI, and 64.3% (9/14) had improved clinical symptoms. CDI led to more hospitalizations (median two times [range 0–12] vs. median one time [range 0–19], p = 0.008), a lower steroid‐free remission rate (46.7% vs. 67.7%, p = 0.017), and higher Mayo scores (median 5 points [range 2–12] vs. median 3 points [range 0–12]). Patients who received FMT had fewer hospitalizations and fewer IBD‐related complications during follow‐up than those who received antibiotics alone. FMT should be considered in patients with IBD with refractory or recurrent CDI to improve clinical outcomes. |
| format | Article |
| id | doaj-art-7beeb6159db742c283a91d2bbbf05f0e |
| institution | Kabale University |
| issn | 1607-551X 2410-8650 |
| language | English |
| publishDate | 2025-05-01 |
| publisher | Wiley |
| record_format | Article |
| series | Kaohsiung Journal of Medical Sciences |
| spelling | doaj-art-7beeb6159db742c283a91d2bbbf05f0e2025-08-20T03:49:36ZengWileyKaohsiung Journal of Medical Sciences1607-551X2410-86502025-05-01415n/an/a10.1002/kjm2.70002Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort StudyPuo‐Hsien Le0Chyi‐Liang Chen1Chia‐Jung Kuo2Pai‐Jui Yeh3Chien‐Chang Chen4Yi‐Ching Chen5Cheng‐Tang Chiu6Hao‐Tsai Cheng7Yung‐Kuan Tsou8Yu‐Bin Pan9Cheng‐Hsun Chiu10Department of Gastroenterology and Hepatology Chang Gung Memorial Hospital Taoyuan Linkou TaiwanMolecular Infectious Disease Research Center Chang Gung Memorial Hospital Taoyuan Linkou TaiwanDepartment of Gastroenterology and Hepatology Chang Gung Memorial Hospital Taoyuan Linkou TaiwanChang Gung Inflammatory Bowel Disease Center Chang Gung Memorial Hospital Taoyuan Linkou TaiwanChang Gung Inflammatory Bowel Disease Center Chang Gung Memorial Hospital Taoyuan Linkou TaiwanChang Gung Microbiota Therapy Center Chang Gung Memorial Hospital Taoyuan Linkou TaiwanDepartment of Gastroenterology and Hepatology Chang Gung Memorial Hospital Taoyuan Linkou TaiwanDivision of Gastroenterology and Hepatology, Department of Internal Medicine New Taipei Municipal Tucheng Hospital New Taipei City Tucheng TaiwanDepartment of Gastroenterology and Hepatology Chang Gung Memorial Hospital Taoyuan Linkou TaiwanBiostatistical Section, Clinical Trial Center Chang Gung Memorial Hospital Taoyuan Linkou TaiwanChang Gung Microbiota Therapy Center Chang Gung Memorial Hospital Taoyuan Linkou TaiwanABSTRACT Clostridioides difficile infection (CDI) worsens the prognosis of patients with inflammatory bowel disease (IBD). This retrospective cohort study aimed to evaluate the risk factors, clinical manifestations, and outcomes of CDI in hospitalized patients with IBD, including those with toxin A/B results between April 2007 and April 2021. Patients were classified into the CDI and control groups. Patients with IBD and recurrent or refractory CDI underwent fecal microbiota transplantation (FMT). A total of 144 inpatients with IBD—45 in the CDI group and 99 in the control group—were analyzed. The incidence of CDI in inpatients with IBD was 31%. The Risk factors for CDI included longer IBD duration, biological therapy failure, and biological use. More patients in the CDI group presented with abdominal pain (77.8% vs. 55.6%, p = 0.011). In the antibiotic treatment‐only group, the symptom improvement rate was 60.7% (17/28), the microbiological cure rate was 89.3% (25/28), and the overall success rate was 71.4% (20/28). After antibiotic treatment and FMT, 71.4% (10/14) of the patients tested negative for CDI, and 64.3% (9/14) had improved clinical symptoms. CDI led to more hospitalizations (median two times [range 0–12] vs. median one time [range 0–19], p = 0.008), a lower steroid‐free remission rate (46.7% vs. 67.7%, p = 0.017), and higher Mayo scores (median 5 points [range 2–12] vs. median 3 points [range 0–12]). Patients who received FMT had fewer hospitalizations and fewer IBD‐related complications during follow‐up than those who received antibiotics alone. FMT should be considered in patients with IBD with refractory or recurrent CDI to improve clinical outcomes.https://doi.org/10.1002/kjm2.70002clinical outcomesClostridioides difficile infectionfecal microbiota transplantationinflammatory bowel diseaserisk factors |
| spellingShingle | Puo‐Hsien Le Chyi‐Liang Chen Chia‐Jung Kuo Pai‐Jui Yeh Chien‐Chang Chen Yi‐Ching Chen Cheng‐Tang Chiu Hao‐Tsai Cheng Yung‐Kuan Tsou Yu‐Bin Pan Cheng‐Hsun Chiu Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study Kaohsiung Journal of Medical Sciences clinical outcomes Clostridioides difficile infection fecal microbiota transplantation inflammatory bowel disease risk factors |
| title | Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study |
| title_full | Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study |
| title_fullStr | Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study |
| title_full_unstemmed | Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study |
| title_short | Impact of Clostridioides difficile Infection on Clinical Outcomes in Hospitalized IBD Patients and the Role of Fecal Microbiota Transplantation: A Retrospective Cohort Study |
| title_sort | impact of clostridioides difficile infection on clinical outcomes in hospitalized ibd patients and the role of fecal microbiota transplantation a retrospective cohort study |
| topic | clinical outcomes Clostridioides difficile infection fecal microbiota transplantation inflammatory bowel disease risk factors |
| url | https://doi.org/10.1002/kjm2.70002 |
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