Polymerase chain reaction test for clostridium difficile toxin B gene reveals similar prevalence rates in children with and without inflammatory bowel disease

Esi S.N. Lamousé-Smith, Sarah Weber, Richard F. Rossi, Liliane J. Neinstedt, Nima Mosammaparast, Thomas J. Sandora, Alexander J. McAdam, Athos Bousvaros

Research output: Contribution to journalArticle

16 Scopus citations

Abstract

Objective: Clinicians often evaluate for Clostridium difficile infection (CDI) in patients with inflammatory bowel disease (IBD) presenting with exacerbations. A highly sensitive polymerase chain reaction (PCR) test for the toxin B gene of C difficile is increasingly used to diagnose CDI. The aim of this study was to determine the prevalence of positive C difficile PCR results in children and young adults with and without active IBD compared with patients with non-IBD gastrointestinal disease. Methods: Fecal samples were obtained from patients with ulcerative colitis (UC, n=76) or Crohn disease (CD, n=69) and 51 controls followed in our gastroenterology program. Samples were analyzed for C difficile using a PCR test for the C difficile toxin B gene (BD GeneOhm Cdiff assay). Proportions of positive tests in each group were compared using the Pearson χ test. Results: The prevalence of positive PCR results was 11.6% in patients with CD, 18.4% in patients with UC, and 11.8% in controls (P=0.25). There were no significant differences in the prevalence of positive C difficile results among patients with IBD with and without active disease or among patients with and without diarrhea. Conclusions: Positive C difficile PCR results occur with similar frequency in patients with IBD with and without active disease and in patients with other gastrointestinal diseases. A positive result in a highly sensitive PCR assay that detects low copy numbers of a toxin gene in C difficile may reflect colonization in a subset of patients with IBD, confounding clinical decision making in managing disease exacerbations.

Original languageEnglish
Pages (from-to)293-297
Number of pages5
JournalJournal of pediatric gastroenterology and nutrition
Volume57
Issue number3
DOIs
StatePublished - Sep 1 2013

Keywords

  • Clostridium difficile
  • Crohn disease
  • diarrhea
  • inflammatory bowel disease
  • ulcerative colitis

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