Table 2.
Risk factors for Clostridium difficile infection in inflammatory bowel disease
| Ref. | Sampling time frame | Setting | Diagnosis method |
Identified risk factors |
|
| HOST | ENVIRONMENT | ||||
| Razik et al[44] (2016) | 2010-2013 | Inpatient | PCR | Non-ileal CD | Hospitalisation for CDI; recent antibiotic use; biologic therapy; 5-ASA; Steroids |
| McCurdy et al[54] (2016) | 2005-2011 | Inpatient and outpatient | PCR | CMV infection | N/A |
| Seril et al[45] (2014) | 2010-2013 | Inpatient and outpatient | PCR for Toxin B | Post-surgery mechanical intestinal complications; low serum immunoglobulin level | None identified |
| Regnault et al[30] (2014) | 2008-2010 | Inpatient | Stool culture on selective medium + cytotoxicity assay +/- toxigenic culture | None identified | NSAIDs |
| Connelly et al[52] (2014) | N/R | N/R | PCR for Toxin A gene | IL-4 gene associated SNP rs2243250 | Not studied |
| Ananthakrishnan et al[102] (2014) | 1998-2010 | Inpatient | N/R | Low vitamin D concentration | Not studied |
| Ananthakrishnan et al[56] (2013) | N/R | Inpatient and outpatient | ELISA for Toxin A/B | Female sex; pancolitis; IBD-related SNPs | Protective : Anti-TNF therapy |
| Monaghan et al[53] (2013) | 2009-2012 | N/R | Toxigenic culture | Impaired ability to generate: toxin-specific antibody, memory B-cell responses | Not studied |
| Li et al[34] (2013) | 2010-2011 | Outpatient | PCR for Toxin B | None identified | Recent hospitalization |
| Masclee et al[47] (2013) | 2009-2010 | Outpatient | PCR for C. difficile and Toxins A/B | None identified | None identified |
| Kaneko et al[46] (2011) | 2006-2009 | Inpatient and outpatient | ELISA for Toxin A | None identified | None identified |
| Kariv et al[43] (2011) | 2000-2006 | Inpatient and outpatient | EIA for Toxin A/B | Recent surgery | Recent antibiotic use; recent hospitalization |
| Ricciardi et al[27] (2009) | 1993-2003 | Inpatient | N/R | Colonic involvement | Not studied |
| Schneeweiss et al[49] (2009) | 2001-2006 | Inpatient and outpatient | N/R | Not studied | Corticosteroid initiation |
| Nguyen et al[17] (2008) | 1998-2004 | Inpatient | N/R | Colonic involvement | Not studied |
| Comorbidity | |||||
| Issa et al[24] (2007) | 2005 | Inpatient | ELISA for Toxin A/B | Colonic involvement | Maintenance immunomodulator use |
| Rodemann et al[16] (2007) | 1998-2004 | Inpatient | Cell cytotoxic culture | Age | Not studied |
| 2002 onwards C. difficile Toxin A/B immunoassay | Comorbidity | ||||
| Mylonaki et al[23] (2004) | 1997-2001 | Inpatient | ELISA for Toxin A/B | None identified | Recent antibiotic use |
CDI: Clostridium difficile infection; rCDI: Recurrent Clostridium difficile infection; IBD: Inflammatory bowel disease; UC: Ulcerative colitis; CD: Crohn’s Disease; IPAA: Ileal anal-pouch anastomosis; CMV: Cytomegalovirus; CF: Cystic fibrosis; EIA: Enzyme immunoassay; ELISA: Enzyme linked immunosorbent assay; NSAID: Non-steroidal anti-inflammatories PCR: Polymerase chain reaction; N/R: Not reported.