Intest Res.  2018 Apr;16(2):267-272. 10.5217/ir.2018.16.2.267.

Is Clostridium difficile infection a real threat in patients with ulcerative colitis? A prospective, multicenter study in Korea

  • 1Department of Internal Medicine, St. Vincent's Hospital, College of Medicine, The Catholic University of Korea, Suwon, Korea.
  • 2Department of Internal Medicine, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea.
  • 3Department of Internal Medicine, Seoul Paik Hospital, Inje University College of Medicine, Seoul, Korea.
  • 4Department of Internal Medicine, Kyungpook National University Hospital, School of Medicine, Kyungpook National University, Daegu, Korea.
  • 5Department of Internal Medicine, Chosun University Hospital, Chosun University College of Medicine, Gwangju, Korea.
  • 6Department of Internal Medicine, Ewha Womans University Medical Center, Ewha Womans University School of Medicine, Seoul, Korea.
  • 7Department of Internal Medicine, Wonkwang University Hospital, Wonkwang University College of Medicine, Iksan, Korea.


Clostridium difficile infection (CDI) has been reported to be a cause of flare-ups in patients with ulcerative colitis (UC). We evaluated the prevalence and clinical outcomes of CDI in patients with UC hospitalized for flare-ups.
This was a prospective, multicenter study including 7 academic teaching hospitals in Korea. All consecutive patients with UC admitted for disease flare-up were enrolled. We detected the presence of CDI by using enzyme immunoassay, real-time polymerase chain reaction (RT-PCR) for toxin genes, and sigmoidoscopy.
Eighty-one consecutive patients with UC were enrolled from January 2014 to December 2015. Among 81 patients, 8 (9.9%) were diagnosed with CDI. Most of the cases were identified by RT-PCR. Enzyme immunoassay was positive in 3 of 8 patients, and only 1 had typical endoscopic findings of pseudomembranous colitis. There were no differences in demographic data, length of hospital stay, or colectomy rate between patients with and without CDI.
CDI was not a rare cause of flare-up in patients with UC in Korea. However, CDI did not appear to affect the course of UC flare-up in Korean patients. RT-PCR was sensitive in detecting CDI and can be considered a diagnostic tool in patients with UC flare-up.


Colitis, ulcerative; Clostridium infections; Prevalence; Polymerase chain reaction

MeSH Terms

Clostridium difficile*
Clostridium Infections
Colitis, Ulcerative*
Enterocolitis, Pseudomembranous
Hospitals, Teaching
Immunoenzyme Techniques
Length of Stay
Polymerase Chain Reaction
Prospective Studies*
Real-Time Polymerase Chain Reaction
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