Curr Gastroenterol Rep. 2023 Nov;25(11):316-322.doi: 10.1007/s11894-023-00890-9. Epub 2023 Aug 30.

Seth A Reasoner ¹, Maribeth R Nicholson ^2 3

Author information

¹Division of Molecular Pathogenesis, Department of Pathology, Microbiology & Immunology, Vanderbilt University Medical Center, Nashville, TN, USA.

²Immunology & Inflammation (VI4), Vanderbilt Institute for Infection, Vanderbilt University Medical Center, Nashville, TN, USA. maribeth.r.nicholson@vumc.org.

³Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Monroe Carrell Junior Children's Hospital at Vanderbilt, Nashville, TN, USA. maribeth.r.nicholson@vumc.org.

Abstract

Purpose of review: Children with inflammatory bowel disease (IBD) are at increased risk of C. difficile infection (CDI) and experience worse outcomes associated with an infection. In this article, we review recent research on the incidence, diagnosis, complications, and treatment options for CDI in children with IBD.

Recent findings: Children with IBD have an elevated incidence of CDI, but their CDI risk does not associate with established risk factors in adults with IBD. Existing testing methodologies are inadequate at differentiating CDI from C. difficile colonization in children with IBD. Fecal microbiota transplantation offers a durable cure for recurrent CDI. CDI remains a frequent occurrence in children with IBD. Careful clinical monitoring should be used to diagnose CDI and patients with co-occurring IBD and CDI require careful surveillance for worse outcomes. Future research should explore the optimal diagnosis and treatment modalities in this unique patient population.