Dr Preethi Venkat Discusses Differences in Hospitalizations for C diff, IBD Only

At Digestive Disease Week 2022, Preethi Venkat, MD, second-year internal medicine resident at the University of California, San Diego, spoke with The American Journal of Managed Care® (AJMC®) about her findings on recurrent Clostridioides difficile (C diff) infection in patients with inflammatory bowel disease (IBD). This interview is lightly edited for clarity.

AJMC®: Why did patients with IBD hospitalized for C diff have poor outcomes compared with patients with IBD hospitalized for other reasons?

Venkat: Again, this part of the study was sort of an expected finding and has been supported by existing literature. But really, what it suggests is that there’s something specific to infection with C difficile that alters the gut microbiome and increases the risk of complications in patients with IBD that is not otherwise conferred by recurrent hospitalizations alone for alternative reasons. But what was surprising was the finding that recurrent hospitalizations for C diff did not seem to further increase risk of adverse outcomes. This kind of leads to some of the other questions, but it could be related in part to misclassification bias and lack of power in our sample.

AJMC®: How should your findings be implemented into similar research going forward?

Venkat: Absolutely. I think future studies, specifically with a larger sample of patients with IBD who are hospitalized with recurrent C difficile infection, might allow for adequately powered stratified analyses to kind of examine this question further. That was one limitation that, in the cohort of patients who are hospitalized with 2 or more admissions for C diff in that 1-year period, was quite limited compared to a greater sample. So, there’s a possibility that we didn’t have adequate power in that group. Controlling for misclassification of C difficile infection would also help to minimize bias in subsequent studies.