Impact of fecal microbiota on Clostridioides difficile infection status in paediatric subjects with inflammatory bowel diseases

Children with inflammatory bowel diseases (IBD) are particularly vulnerable to Clostridioides difficile infections (CDI) and experience significantly worse health outcomes including increased hospitalisation and shorter time to their first bowel resection. Previous studies have correlated these outcomes to specific features of the gastrointestinal microbiome of paediatric patients post-CDI. However, data regarding features that may predispose pediatric IBD patients to CDI is lacking. Furthermore, it is not known whether CDI has long-term impacts on the microbiome of IBD-CDI patients on remission. In this context, our primary aims were to investigate whether paediatric IBD-CDI patients had a distinct microbiota at baseline compared to paediatric IBD controls and to examine whether IBD-CDI patients had a distinct microbiome during remission than those who did not develop CDI. Finally, our secondary aim was to assess whether IBD patients with CDI required more biologic therapy.