Specific features of clostridium difficile colitis in patients with inflammatory bowel disease

Abstract

Through its specific biological, epidemiological, diagnostic and infection management features, Clostridium difficile infection (CDI) can be considered a major health concern, especially in inflammatory bowel disease (IBD) patients. In this particular infection, many IBD risk factors are triggered due to bowel inflammation, antibiotics use, microbiota changes, immunosuppressive therapy use and surgical intervention. Thus, each IBD and diarrhea patient must be tested for CDI. Clinical features show different initial infectious stages such as mild, fulminate and refractory. It has been shown that CDI presents recurrent episodes. CDI treatment consists of metronidazole, vancomycin or fidaxomicin, as well as prophylactic measures. It was recently shown that antibiotic doses must be gradually reduced in order to avoid CDI relapses. Fecal transplantation, effective in CDI management, remains controversial in CDI patients with concurrent IBD.

Keywords

• Clostridium difficile
• infection
• inflammatory bowel disease
• diarrhea
• Clostridium difficile toxins