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P637. Clostridium difficile infection rate in inflammatory bowel disease patients in a tertiary center in Israel

Background

Clostridium difficile infection (CDI) rate in inflammatory bowel disease (IBD) patients has been increasing compared to non-IBD populations. IBD is considered a risk factor for CDI infection, and once infected these patients are at an increased risk for complications and mortality. The rate of CDI in hospitalized IBD patients is 5–19%. Despite the high prevalence of IBD in the Jewish population in Israel, the rate of CDI in IBD patients in Israel has not been evaluated.

Our aim in the current study was to find the rate and clinical implications of CDI in hospitalized IBD patients.

Methods

In this retrospective analysis, all hospitalized IBD cases (according to the ICD-9 codes) between 1/7/2008 to 31/7/2013 that were tested for CDI in the Tel Aviv Sourasky Medical Center, a large tertiary center in Israel, were included. Patients that were post total colectomy were excluded from the study. Clinical data were retrieved from electronic patient files.

Results

A total of 541 IBD (190 UC; 358 CD) patients were tested for CDI during the study period. Of these, 6.5% (10.4% UC; 5% CD) patients tested positive for C. difficile toxin. Infected patients were older than non-infected patients (57±23 vs 47±20 years, P < 0.01), their mean hospitalization duration was longer (17.3±18.5, 10.9±15, P < 0.05) and they were more frequently hospitalized within the prior 2 months of CDI (1.14±1.35 vs 0.45±0.86, P < 0.01). No difference in the number of subsequent hospitalizations during the year following CDI was noticed.

Conclusion

The rate of C. difficile infection in hospitalized IBD patients in a tertiary center in Israel is 6.5%, within the range of worldwide reported series. CDI is associated with longer hospitalization periods. These data underscore the importance of detection and treatment of C. difficile in IBD patients.

  • Written by:

    N. Maharshak, A. Ofer, O. Davidov, I. Dotan, Tel Aviv Medical Center, affiliated to the Sackler Faculty of Medicine, Tel Aviv University, Department of Gastroenterology and Liver Diseases, Tel Aviv, Israel