Incidence of Clostridium difficile in Hispanics With Inflammatory Bowel Disease and Association With ATG16L1 and NOD2 Single Nucleotide Polymorphisms

摘要: Background Clostridium difficile (C. difficile) disease incidence is rising among patients with inflammatory bowel disease (IBD). Recently risk of infection has been associated with ATG16L1 and NOD2 single nucleotide polymorphisms (SNPs). Despite being the fastest growing minority group in the US, there is little data about C. difficile in Hispanics with IBD. Our aim was to evaluate incidence of and risk factors for C. difficile in Hispanics with IBD and evaluate potential association with ATG16L1 and NOD2 SNPs. Methods We enrolled IBD patients seen from 2010 to 2014 at a single-center (comprised of a large public hospital and a tertiary referral center) in a major metropolitan area with a large Hispanic population. DNA was obtained via buccal swabs and real time PCRs for ATG16L1 (rs2241990, rs3828309) and NOD2 (rs2066844, rs2066845) were performed. The medical chart was reviewed for disease subtype (Crohn's disease [CD] or ulcerative colitis [UC]), medication/surgical history and history of C. difficile infection history. Results A total of 221 patients were included for analysis of which 138 (62%) were Hispanic and 83 (38%) were non-Hispanic. Of Hispanics with IBD, 25 (18%) had a positive C. difficile PCR compared to 18 (22%) of non-Hispanics (p= 0.59). In our CD cohort, there were no major differences between Hispanics and non-Hispanics with positive C. difficile with regard to disease distribution (ileal, colonic vs ileocolonic) or behavior (luminal vs stricturing/penetrating). Hispanic CD patients with C. difficile did have lower rates of surgery compared to non-Hispanics with C. difficile (p= 0.035). In the UC cohort, there was no …