Prevalence and Risk Factors of Clostridium Difficile Infection in Patients with IBD in a Tertiary Care Hospital, in South India

Background: Inflammatory Bowel Disease (IBD) patients are increasingly susceptible to Clostridium difficile infection (CDI), a critical healthcare-associated challenge characterized by complex interactions between immunological alterations, antibiotic exposure, and gut microbiome disruption. This study aims to comprehensively investigate the risk factors, clinical characteristics for CDI among IBD patients in a tertiary care hospital setting. Methods: This cross-sectional observational study was conducted over 12 months, enrolling 20 IBD patients. The study employed comprehensive diagnostic approaches including Glutamate Dehydrogenase (GDH) screening, detailed toxin typing, expanded comorbidity assessment, and thorough symptom evaluation. Stool samples underwent rigorous microbiological investigations, including rapid antigen detection, molecular testing, bacterial culture, and antibiotic susceptibility testing. Statistical analysis utilized SPSS software, with descriptive statistics, frequencies, and chi-square tests to assess variable associations. Results: The study revealed a male-predominant population (65%), with 45% aged 31-45 years. Notably, 100% of patients tested positive for GDH, with 80% positive for Toxin A and 40% for Toxin B. Comorbidities were significant, with 40% having diabetes mellitus. Symptomatology was pronounced, with 90% experiencing fever and 100% reporting abdominal pain. Symptom severity was predominantly mild (80%), with 20% classified as severe. Antibiotic usage data indicated that 30% of patients had taken Ciprofloxacin and 15% had used Metronidazole before diagnosis. Conclusion: The study provides critical insights into the CDI-IBD relationship, highlighting the need for enhanced screening protocols, targeted antimicrobial interventions, and personalized patient monitoring strategies. Future research should focus on larger, multi-center studies and detailed investigations of gender-specific risk factors.