A positive Clostridioides difficile test does not impact outcomes in hospitalized patients with acute severe ulcerative colitis.

BACKGROUND

Clostridioides difficile infection (CDI) is a significant complication in patients with acute severe ulcerative colitis (ASUC).

OBJECTIVES

To assess the clinical outcomes of hospitalized ASUC patients with CDI.

DESIGN

Retrospective, single-center study.

METHODS

Medical records of ASUC patients admitted from December 1, 2008, to June 1, 2018, were reviewed. Primary outcomes included hospital duration, in-hospital colectomy rates, and escalation of immunosuppression at discharge. Secondary outcomes included readmission rates and use of salvage therapy.

RESULTS

Among 410 ASUC patients, 67 tested positive for CDI. No significant differences in hospital duration, colectomy rates, or readmission rates were found between CDI-positive and CDI-negative groups. CDI-positive patients were less likely to receive intravenous corticosteroids.

CONCLUSION

A positive CDI test in ASUC patients does not correlate with worse clinical outcomes. Based on these results, CDI should be ruled out and treated in hospitalized patients with severe ulcerative colitis without delaying ASUC management.