title: Occurrence of Clostridium difficile toxin during the course of inflammatory bowel disease.
abstract: Clostridium difficile toxin, the presumed mechanism of antibiotic-associated pseudomembranous colitis, has been suggested as a contributory factor to mucosal injury in inflammatory bowel disease. We evaluated its incidence and apparent role in 65 consecutive patients with diarrheal and inflammatory bowel diseases. Toxin was demonstrated in 3 of 18 patients with ulcerative colitis (17%), 1 of 26 with Crohn's colitis (4%), and 5 of 21 with a variety of diarrheal illnesses (24%). Toxin appeared only in those who had been exposed to antimicrobials within 2 mo. In inflammatory bowel disease, presence of toxin was not correlated with disease severity. We conclude that Clostridium difficile toxin appears only in patients exposed to antimicrobials and is unlikely to be a significant contributory factor in inflammatory bowel disease.
mesh_terms: D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D003013:Clostridium / Q000276:immunology; D004731:Endotoxins / Q000032:analysis*; D004761:Enterocolitis, Pseudomembranous / Q000188:drug therapy*; D006801:Humans; D007249:Inflammation; D007410:Intestinal Diseases / Q000276:immunology*
chemical_list: D000900:Anti-Bacterial Agents; D004731:Endotoxins