Abstract Background To investigate the clinical characteristics of Ulcerative colitis (UC) patients receiving Infliximab (IFX) or Vedolizumab (VDZ) treatment, as well as the risk factors for concurrent Clostridium difficile infection (CDI). Methods Patients hospitalized in the Department of Gastroenterology, Shengjing Hospital of China Medical University, who were clearly diagnosed with UC and received IFX or VDZ treatment between January 2019 and May 2025 were enrolled in this study. Data collected included patients’ general information, laboratory test results, disease-related data, information on combined medication use within 2 months before admission, and therapeutic medications for patients with CDI during hospitalization. The clinical characteristics of the patients were analyzed, and the risk factors for CDI in the patients were identified. Results A total of 110 patients with UC were enrolled in this study. The positive rate of Clostridioides difficile (C. diff) was 28.2%, among which the CDI rate was 23.6% and the C. diff colonization rate was 4.5%. Results of univariate logistic analysis showed that a positive purified protein derivative (PPD) test, concurrent Epstein-Barr virus (EBV) infection, a modified Mayo score ≥11 points, and a history of hormone use within 2 months before admission were associated with an increase the risk of CDI; For UC patients receiving IFX or VDZ treatment, concurrent CDI were associated with fever or prolonged hospital stay (all P 0.05). Multivariate logistic regression analysis revealed that concurrent EBV infection, a modified Mayo score ≥11 points, and a history of hormone use within 2 months before admission were likely independent risk factors for concurrent CDI in UC patients treated with IFX or VDZ (P 0.05). Indication of inter-group comparison: in the IFX group, the C. diff positive rate was 23% and the infection rate was 18%; in the VDZ group, the C.diff positive rate was 34.7% and the infection rate was 30.6%. But no statistically significant differences were observed in the positive rate or infection rate between the two groups (positive rate: P = 0.174; infection rate: P = 0.123). Analysis of the onset time of CDI in patients from both groups indicated that among UC patients who initiated biological agent (VDZ/IFX) treatment, the proportion of CDI cases occurring within 0-3 months was the highest, but this difference was not statistically significant. Conclusion Concurrent EBV infection, a modified Mayo score ≥11 points, and a history of hormone use within 2 months before admission may be independent risk factors for CDI in UC patients receiving IFX or VDZ treatment. Conflict of interest: Xu, Tingting: No conflict of interest Tian, Feng: No conflict of interest Xie, Ying: No conflict of interest
Xu et al. (Thu,) studied this question.