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The Prevalence of Clostridium difficile Infection in Pediatric and Adult Patients with Inflammatory Bowel Disease

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Abstract

Objectives

Adults with inflammatory bowel disease (IBD) have a high prevalence of Clostridium difficile infection (CDI). CDI in children with IBD may differ from adults. We aim to compare the prevalence of CDI in hospitalized pediatric and adult IBD patients and patients without IBD.

Methods

The rates of CDI per 1,000 IBD and non-IBD hospitalizations between 1993 and 2012 were examined using the Maryland Health Services Cost Review Commission database. Age, sex and calendar year adjusted incidence rate ratios comparing CDI in pediatrics and adults by type of IBD and with patients without IBD were calculated. p values for trend identifying changes in rates over time were calculated.

Results

Among children, the rate of CDI was over 12 times greater in IBD than non-IBD hospitalizations (p < 0.0001) and among adults, the rate of CDI was four times greater in IBD than non-IBD hospitalizations (p < 0.0001). In adults, CDI was significantly higher in ulcerative colitis (UC) than Crohn’s disease (60.4 per 1,000 vs. 19.8 per 1,000, p < 0.0001) but in children there was no difference in CDI in UC compared with Crohn’s disease (32 per 1,000 vs. 27 per 1,000, p = 0.45). The prevalence of CDI increased in pediatric and adult IBD patients, and patients without IBD, between 1993 and 2012 (p for trend <0.0001).

Conclusions

CDI was more common in adult patients with UC, and no difference was found between CDI and IBD type in pediatrics. There may be different risk factors for CDI during hospitalization between adults and children with IBD.

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Conflict of interest

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Authors and Affiliations

  1. Division of Pediatric Gastroenterology and Nutrition, Johns Hopkins School of Medicine, Brady 320, 600 N. Wolfe Street, Baltimore, MD, 21287, USA

    S. K. Hourigan & M. Oliva-Hemker

  2. Pediatric Gastroenterology, Hepatology and Nutrition, Pediatric Specialists of Virginia, 8505 Arlington Blvd, Suite 400, Fairfax, VA, 22031, USA

    S. K. Hourigan

  3. Division of Gastroenterology, Johns Hopkins School of Medicine, Baltimore, MD, USA

    S. Hutfless

Authors
  1. S. K. Hourigan
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  2. M. Oliva-Hemker
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  3. S. Hutfless
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Corresponding author

Correspondence to S. K. Hourigan.

Additional information

This work is exempt from IRB approval, as per the Johns Hopkins Hospital IRB, because is uses de-identified data from a database accessible to the public.

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Hourigan, S.K., Oliva-Hemker, M. & Hutfless, S. The Prevalence of Clostridium difficile Infection in Pediatric and Adult Patients with Inflammatory Bowel Disease. Dig Dis Sci 59, 2222–2227 (2014). https://doi.org/10.1007/s10620-014-3169-4

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  • DOI: https://doi.org/10.1007/s10620-014-3169-4

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