Carriage of Clostridium difficile in outpatients with irritable bowel syndrome

Irritable bowel syndrome (IBS) is a common, typically chronic and sometimes disabling gastrointestinal condition of uncertain aetiology. Recently, a variety of links to gastrointestinal infections have been described including the onset of IBS following exposure to enteric pathogens and an apparent predisposition to gastrointestinal infection. The prevalence of Clostridium difficile in a population of IBS outpatients (n=87) in the absence of established risk factors for the acquisition of C. difficile infection was examined. Overall, 5.7% of patients (n=5) carried culturable C. difficile and 4.6% (n=4) of isolates were toxigenic, belonging to toxinotype group 0, compared with 1.1% (n=1) for the healthy control group (n=88). These isolates were members of toxigenic PCR ribotype groups 005 and 050 (IBS group) and 062 (control group) and were identified further as three individual strains by PFGE. Although no significant difference was observed between IBS patients and healthy volunteers, these findings support the concept that a subpopulation of IBS patients may be susceptible to gastrointestinal infection.