Acute inflammatory bowel disease (IBD) exacerbations may include an enteric infection. The purpose of this study was to look at the prevalence and consequences of Clostridium difficile toxin (CDT) and non-CDT enteric infections in symptomatic juvenile IBD patients. Patients’ records were reviewed retrospectively for disease flares, and stool samples were collected to test for enteric pathogens. Each patient who had a positive sample was matched with a patient who had an IBD flare and a patient who had a negative sample for the purpose of assessing 1-year outcomes after sampling. During the research period, 1048 stool samples were collected from 618 paediatric IBD patients. Thirty bacterial cultures out of 914 were positive, 30 of which were positive for Campylobacter jejuni. CDT was detected in 28 of 393 samples, with parasite infection occurring in 21/529. There were 19 positive C jejuni cases and 19 positive CDT cases with matched controls in total. During a 12-month follow-up period, patients with positive CDT had a greater mean number of illness flares and emergency department visits, as well as a numerical increase in surgical procedures. There were no statistically significant differences in illness outcomes between C jejuni patients and matched controls.
Although C difficile and C jejuni are the most frequent enteric infections in juvenile IBD patients, only clostridial infection was linked to a more severe disease course within 12 months.