Risk factors for Clostridioides difficile infection among patients diagnosed with inflammatory intestinal and rheumatological diseases in the biologic era

Clostridioides difficile infection (CDI) in inflammatory bowel disease (IBD) has been associated with poor clinical outcomes. The relationship between biologic therapy and CDI is controversial. We aimed to assess whether biologic therapy increases CDI risk among IBD patients, to identify factors ass...

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Bibliographic Details
Published in:BMC gastroenterology 2025-02, Vol.25 (1), p.70-10, Article 70
Main Authors: Martínez-Lozano, Helena, Saralegui-Gonzalez, Paula, Reigadas, Elena, Fueyo-Peláez, Pablo Ramón, García-García, Aurea, Miranda-Bautista, José, Alcalá, Luis, Nieto, Juan Carlos, Lobato-Matilla, María Elena, Marín-Jiménez, Ignacio, Muñoz, Patricia, Menchén, Luis
Format: Article
Language:English
Subjects:
Adult
Aged
Arthritis
Asymptomatic
Biological products
Biological Products - adverse effects
Biological Products - therapeutic use
Biologics
Biopharmaceuticals
Clostridioides difficile
Clostridium Infections - complications
Clostridium Infections - epidemiology
Cohort Studies
Colitis, Ulcerative - complications
Colitis, Ulcerative - drug therapy
Colorectal surgery
Creatinine
Crohn Disease - complications
Crohn Disease - drug therapy
Crohn's disease
Female
Health facilities
Humans
Hypotension
Immune-mediated inflammatory diseases
Incidence
Infections
Infectious diseases
Inflammatory bowel disease
Inflammatory bowel diseases
Inflammatory Bowel Diseases - complications
Inflammatory Bowel Diseases - drug therapy
Inflammatory diseases
Leukocytes
Logistic Models
Male
Middle Aged
Mortality
Patients
Population
Rheumatic diseases
Rheumatic Diseases - complications
Rheumatic Diseases - drug therapy
Rheumatic Diseases - epidemiology
Risk Factors
Steroids
Toxins
Ulcerative colitis
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Summary:Clostridioides difficile infection (CDI) in inflammatory bowel disease (IBD) has been associated with poor clinical outcomes. The relationship between biologic therapy and CDI is controversial. We aimed to assess whether biologic therapy increases CDI risk among IBD patients, to identify factors associated with increased CDI risk, and to characterize CDI episodes in our population. We included patients diagnosed with IBD (IBD-cohort) and immune-mediated inflammatory rheumatic diseases (Rheuma-cohort). Risk factors for CDI were assessed using a logistic regression model. We also estimated the incidence rate of CDI for each biologic. We included 1866 patients: 1041 from the IBD-cohort and 825 from the Rheuma-cohort. The diagnosis of IBD was the major risk factor for developing CDI in the overall population (OR: 18.29, CI 95%: 5.59-59.80, p 
ISSN:1471-230X
1471-230X
DOI:10.1186/s12876-025-03650-3