J Pediatr Gastroenterol Nutr. 2024 Dec 20. doi: 10.1002/jpn3.12439. Online ahead of print.

Seth A Reasoner ¹, Lisa S Zhang ², Rachel Bernard ², Kathryn M Edwards ³, Maribeth R Nicholson ^2 4

Author information

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

²Division of Pediatric Gastroenterology, Hepatology, and Nutrition, Department of Pediatrics, Monroe Carell Junior Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.

³Division of Pediatric Infectious Diseases, Department of Pediatrics, Monroe Carell Junior Children's Hospital at Vanderbilt, Nashville, Tennessee, USA.

⁴Vanderbilt Institute for Infection, Immunology and Inflammation, Vanderbilt University Medical Center, Nashville, Tennessee, USA.

Abstract

Colonization by Clostridioides difficile is common in children with inflammatory bowel disease (IBD) and complicates both the management of IBD and the diagnosis of C. difficile infection (CDI). There is a paucity of data on rates, risk factors, and outcomes associated with asymptomatic C. difficile colonization in children with IBD. We enrolled and prospectively followed 87 children with IBD without acute gastrointestinal symptoms. Twelve patients (13.8%) tested positive for C. difficile and were considered to have asymptomatic colonization. Elevated white blood cell count was associated with C. difficile colonization based on univariate regression. Three of the 12 (25%) C. difficile colonized patients were diagnosed with CDI in the 90 days following screening for C. difficile, versus 0 of the 75 who tested negative for C. difficile (p = 0.002). This data set the stage for further longitudinal tracking of children with IBD for C. difficile colonization and associated outcomes.