Novel risk factors and outcomes in inflammatory bowel disease patients with Clostridioides difficile infection
Open Access
- 1 January 2021
- journal article
- research article
- Published by SAGE Publications in Therapeutic Advances in Gastroenterology
Abstract
Patients with inflammatory bowel disease (IBD) are at significantly increased risk for Clostridioides difficile infection (CDI) with an increased risk of adverse outcomes including increased in-hospital mortality, IBD treatment failure, re-hospitalization, and high CDI recurrence rates. The existing literature on predictors of these adverse outcomes is limited. We evaluated four potentially modifiable novel risk factors [body mass index (BMI), statin use, opioid use, and antidepressant use] on CDI risk and adverse outcomes in these patients. Using a retrospective design, variables were abstracted from records for patients with IBD and CDI from 2008 to 2013. Statistical analysis comprised descriptive statistics and univariate and multivariate logistic regression analyses. There were 137 patients with IBD and CDI included in this study. On multivariate analysis controlling for age, 43% of patients in the overweight BMI category had severe or severe, complicated CDI, compared with 22% of patients in the underweight/normal BMI [odds ratio (OR) 2.85, p = 0.02] and 19% in the obese category (OR 3.95, p = 0.04). Statin use was associated with severe or severe, complicated CDI when controlling for age and BMI (OR 5.66, p = 0.01). There was no association between statin use and IBD exacerbations following CDI. Opioid and antidepressant use were not associated with disease severity or frequency of IBD exacerbations following CDI. An overweight BMI and statin use were associated with severe or severe, complicated CDI in IBD patients. Further studies are needed to better understand how these factors impact management of patients with IBD to improve clinical outcomes and potentially reduce the risk of complications from CDI.Keywords
This publication has 31 references indexed in Scilit:
- Depression, antidepressant medications, and risk of Clostridium difficileinfectionBMC Medicine, 2013
- Is Statin Use Associated with Reduced Mortality After Pneumonia? A Systematic Review and Meta-analysisThe American Journal of Medicine, 2012
- Moderate to High Use of Opioid Analgesics Are Associated With an Increased Risk of Clostridium difficile InfectionThe American Journal of the Medical Sciences, 2012
- Predictors of severe outcomes associated with Clostridium difficile infection in patients with inflammatory bowel diseaseAlimentary Pharmacology & Therapeutics, 2012
- Practice of gastroenterologists in treating flaring inflammatory bowel disease patients with clostridium difficileInflammatory Bowel Diseases, 2011
- Clinically important interaction between statin drugs and Clostridium difficile toxin?Medical Hypotheses, 2009
- Antimotility Agents for the Treatment ofClostridium difficileDiarrhea and ColitisClinical Infectious Diseases, 2009
- Resistin is an inflammatory marker of inflammatory bowel disease in humansEuropean Journal of Gastroenterology & Hepatology, 2007
- Impact of Clostridium difficile on Inflammatory Bowel DiseaseClinical Gastroenterology and Hepatology, 2007
- Human gut microbes associated with obesityNature, 2006