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P380. Incidence of Clostridium difficile infection in IBD patients compared to oncology and immunocompetent patients

P380. Incidence of Clostridium difficile infection in IBD patients compared to oncology and immunocompetent patients

I. Hojsak, Z. Misak, A. Jaklin Kekez, O. Jadresin, S. Kolacek

Children's Hospital Zagreb, Zagreb, Croatia

Background and Aim: An increased incidence and virulence of Clostridium difficile (CD) with inflammatory bowel disease (IBD) in adults has been reported in several studies. On the other hand, only two studies confirmed increased incidence in pediatric IBD patients [1,2]. Other well-recognized risk factor for acquisition of CD is immunosuppression with greater frequency of CD infection in oncology patients undergoing chemotherapy [3,4]. Our aim was to evaluate incidence of CD in patients with IBD and to compare it to immunosuppressed oncology patients and other tested not immunosuppressed patients.

Methods: We retrospectively analysed data of all patients tested for CD in Children's Hospital Zagreb from January 2006 to September 2009. All stool specimens were analyzed using enzyme immunoassay for the detection of CD A and B toxins. All samples were collected from hospitalized children: IBD patients were hospitalized due to active disease (newly diagnosed or flare of the disease), oncology patients were undergoing chemotherapy, and other hospitalized patients which were not immunosuppressed and had symptoms of diarrhoea with/without blood.

Results: During observational period 482 stool samples from 290 patients (157 (54.1%) male, 133 (45.9%) female; age range 1–18 years, median 11 years) were analysed: 143 samples from 63 patients with IBD; 183 samples from 83 oncology patients and 156 samples from 144 not immunosuppressed patients presented with diarrhoea. We found overall low incidence of CD infection (26/482). No statistically significant difference in CD infection between IBD patients and other not immunosuppressed patients (6/143 vs 8/156, p = 0.70); UC vs Crohn's disease (3/36 vs 3/27, p = 0.20); IBD vs immunosuppressed oncology patients (6/143 vs 12/183, p = 0.36) and immunosuppressed oncology patients vs other not immunosuppressed patients (12/183 vs 8/156, p = 0.58).

Conclusion: Our study did not confirm higher incidence of CD infection in IBD or immunosuppressed patients which could be explained in very low incidence of CD in our hospital.

1. J Pediatr 2009;154:854–8.

2. Clin Gastroenterol Hepatol. 2007;5(3):339–44.

3. Clin Infect Dis 2008;46(Suppl 1):S12–8.

4. Curr Opin Gastroenterol 2009;25:24–35.