BACKGROUND/AIMS: Clostridium difficile infection (CDI) frequently complicates ulcerative colitis (UC) and can mimic disease flare. Differentiating UC flare from CDI remains a clinical challenge, particularly due to C. difficile colonization. Procalcitonin (PCT) is a serum biomarker for bacterial infections. We hypothesized that PCT would differentiate acute CDI from UC flare and C. difficile colonization. METHODS: A single-center prospective cohort study was conducted from 2013 to 2016. All UC patients with a stool sample for C. difficile testing were eligible. A total of 117 patients were enrolled, while 20 were excluded. Chart review was performed. RESULTS: Among 27 patients with CDI, median PCT was 60.7 (range 26-560.6) pg/mL, while among 90 patients without CDI, median PCT was 56.7 (range 25.1-2,252) pg/mL (p = 0.9). It was found that 14 patients with CDI responded completely to C. difficile treatment (CDI-R), while 8 patients did not and were diagnosed with UC flare (CDI-NR). For CDI-R, median PCT was 104.5 (range 26.3-560.6), compared to 40.3 (range 26.0-116.3) for CDI-NR (p = 0.036). CONCLUSIONS: In UC patients presenting with diarrhea, serum PCT was not significantly higher in UC patients with positive C. difficile testing. However, PCT was significantly elevated in CDI-R versus CDI-NR, suggesting that PCT may have utility in making this discrimination.
BACKGROUND/AIMS: Clostridium difficileinfection (CDI) frequently complicates ulcerative colitis (UC) and can mimic disease flare. Differentiating UC flare from CDI remains a clinical challenge, particularly due to C. difficile colonization. Procalcitonin (PCT) is a serum biomarker for bacterial infections. We hypothesized that PCT would differentiate acute CDI from UC flare and C. difficile colonization. METHODS: A single-center prospective cohort study was conducted from 2013 to 2016. All UC patients with a stool sample for C. difficile testing were eligible. A total of 117 patients were enrolled, while 20 were excluded. Chart review was performed. RESULTS: Among 27 patients with CDI, median PCT was 60.7 (range 26-560.6) pg/mL, while among 90 patients without CDI, median PCT was 56.7 (range 25.1-2,252) pg/mL (p = 0.9). It was found that 14 patients with CDI responded completely to C. difficile treatment (CDI-R), while 8 patients did not and were diagnosed with UC flare (CDI-NR). For CDI-R, median PCT was 104.5 (range 26.3-560.6), compared to 40.3 (range 26.0-116.3) for CDI-NR (p = 0.036). CONCLUSIONS: In UC patients presenting with diarrhea, serum PCT was not significantly higher in UC patients with positive C. difficile testing. However, PCT was significantly elevated in CDI-R versus CDI-NR, suggesting that PCT may have utility in making this discrimination.
Authors: George A Alba; Quynh A Truong; Hanna K Gaggin; Parul U Gandhi; Benedetta De Berardinis; Laura Magrini; Ednan K Bajwa; Salvatore Di Somma; James L Januzzi Journal: Am J Med Date: 2015-07-11 Impact factor: 4.965
Authors: Evelyn M Clayton; Mary C Rea; Fergus Shanahan; Eamonn M M Quigley; Barry Kiely; Colin Hill; R Paul Ross Journal: Am J Gastroenterol Date: 2009-03-24 Impact factor: 10.864
Authors: Mazen Issa; Aravind Vijayapal; Mary Beth Graham; Dawn B Beaulieu; Mary F Otterson; Sarah Lundeen; Susan Skaros; Lydia R Weber; Richard A Komorowski; Josh F Knox; Jeanne Emmons; Jasmohan S Bajaj; David G Binion Journal: Clin Gastroenterol Hepatol Date: 2007-03 Impact factor: 11.382
Authors: Suchitra K Hourigan; Sankar R Chirumamilla; Tracy Ross; Jonathan E Golub; Shervin Rabizadeh; Shehzad A Saeed; Charles O Elson; Ciaran P Kelly; Karen C Carroll; Maria Oliva-Hemker; Cynthia Sears Journal: Inflamm Bowel Dis Date: 2013-12 Impact factor: 5.325
Authors: Klaus R Herrlinger; Rike Dittmann; Gunther Weitz; Jan Wehkamp; Diether Ludwig; Matthias Schwab; Eduard F Stange; Klaus Fellermann Journal: Inflamm Bowel Dis Date: 2004-05 Impact factor: 5.325