Is superinfection a major causative factor for acute flares associated with moderate to severe ulcerative colitis in northern India?

Chen Y, Furuya-Kanamori L, Doi SA, Ananthakrishnan AN, Kirk M. Clostridium difficile infection and risk of colectomy in patients with inflammatory bowel disease: a bias-adjusted meta-analysis. Inflamm Bowel Dis. 2017;23:200–7. https://doi.org/10.1097/MIB.0000000000000998.

Amakye D, Ssentongo P, Patel S, et al. Global patterns of Clostridioides difficile infection in patients with inflammatory bowel disease: A systematic review and meta-analysis of prevalence, epidemiology, and risk factors. Crohn’s & Colitis 360. 2025;7:otaf024. https://doi.org/10.1093/crocol/otaf024.

Fernandopulle ANR, Mayadunne PB, Navarathne NMM. The prevalence of Clostridium difficile infection in a cohort of Sri Lankan patients with acute severe ulcerative colitis. Gastroenterol Hepatol Open Access. 2014;1:00008. https://doi.org/10.15406/ghoa.2014.01.00008.

Article  Google Scholar 

Truelove SC, Witts LJ. Cortisone in ulcerative colitis: final report on a therapeutic trial. Br Med J. 1955;2:1041–8. https://doi.org/10.1136/bmj.2.4947.1041.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Travis SP, Farrant JM, Ricketts C, et al. Predicting outcome in severe ulcerative colitis. Gut. 1996;38:905–10. https://doi.org/10.1136/gut.38.6.905.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Satsangi J, Silverberg MS, Vermeire S, Colombel JF. The Montreal classification of inflammatory bowel disease: controversies, consensus, and implications. Gut. 2006;55:749–53. https://doi.org/10.1136/gut.2005.082909.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Schroeder KW, Tremaine WJ, Ilstrup DM. Coated oral 5-aminosalicylic acid therapy for mildly to moderately active ulcerative colitis: A randomized study. N Engl J Med. 1987;317(26):1625–9. https://doi.org/10.1056/NEJM198712243172603.

Article  CAS  PubMed  Google Scholar 

McDonald LC, Gerding DN, Johnson S, et al. Clinical practice guidelines for Clostridium difficile infection in adults and children: 2017 update by the Infectious Diseases Society of America (IDSA) and Society for Healthcare Epidemiology of America (SHEA). Clin Infect Dis. 2018;66:e1-e48. https://doi.org/10.1093/cid/cix1085.

Article  CAS  PubMed  PubMed Central  Google Scholar 

Kariv R, Navaneethan U, Venkatesh PG, Lopez R, Shen B. Impact of Clostridium difficile infection in patients with ulcerative colitis. J Crohns Colitis. 2011;5:34–40. https://doi.org/10.1016/j.crohns.2010.09.007.

Article  PubMed  Google Scholar 

Kochhar R, Ayyagari A, Goenka MK, Dhali GK, Aggarwal R, Mehta SK. Role of infectious agents in exacerbations of ulcerative colitis in India: A study of Clostridium difficile. J Clin Gastroenterol. 1993;16:26–30. https://doi.org/10.1097/00004836-199301000-00008.

Vaishnavi C, Kochhar R, Bhasin D, Thennarasu K, Singh K. Simultaneous assays for Clostridium difficile and fecal lactoferrin in ulcerative colitis. Trop Gastroenterol. 2003;24:13–6.

PubMed  Google Scholar 

Mundhra S, Thomas D, Jain S, et al. Low prevalence of Clostridioides difficile infection in acute severe ulcerative colitis: A retrospective cohort study from northern India. Indian J Gastroenterol. 2023;42:411–7. https://doi.org/10.1007/s12664-022-01336-2.

Article  PubMed  Google Scholar 

Iyer VH, Augustine J, Pulimood AB, Ajjampur SS, Ramakrishna BS. Correlation between coinfection with parasites, cytomegalovirus, and Clostridium difficile and disease severity in patients with ulcerative colitis. Indian J Gastroenterol. 2013;32:115–8. https://doi.org/10.1007/s12664-012-0302-1.

Article  PubMed  Google Scholar 

Ghoshal U, Singh R, Tejan N, Sahu C, Pandey A, Ghoshal UC. A study to assess the prevalence and risk factors for Clostridioides difficile infection in patients with inflammatory bowel disease in a tertiary care hospital in northern India. J Lab Physicians. 2024;16:267–71. https://doi.org/10.25259/JLP-2023-3-5-(1657).

Article  Google Scholar 

Singh A, Luthra M, Bhardwaj A, et al. Clinical spectrum of acute severe ulcerative colitis in the biologic era: a prospective cohort study from India. Intest Res. 2025.https://doi.org/10.5217/ir.2024.00189.

Kelly CR, Fischer M, Allegretti JR, et al. ACG clinical guidelines: prevention, diagnosis, and treatment of Clostridioides difficile infections. Am J Gastroenterol. 2021;116:1124–47. https://doi.org/10.14309/ajg.0000000000001278.

Article  CAS  PubMed  Google Scholar 

Negrón ME, Barkema HW, Rioux K, et al. Clostridium difficile infection worsens the prognosis of ulcerative colitis. Can J Gastroenterol Hepatol. 2014;28:373–80. https://doi.org/10.1155/2014/914303.

Article  PubMed  PubMed Central  Google Scholar 

Comments (0)

No login
gif