Gillespie William, Marya Neil, Fahed Julien, Leslie Gregory, Patel Krunal, Cave David R
Department of Medicine, University of Massachusetts School of Medicine, 55 Lake Avenue North, Worcester, MA 01604, USA.
Department of Gastroenterology, University of California Los Angeles, Los Angeles, CA, USA.
Gastroenterol Res Pract. 2017;2017:4803262. doi: 10.1155/2017/4803262. Epub 2017 Oct 4.
To investigate the epidemiology and risk factors of infections (CDI) in patients with inflammatory bowel disease (IBD).
This is a retrospective study of patients diagnosed with IBD. 1006 charts were screened and 654 patients met the inclusion criteria. Patients were divided into 2 cohorts based on the presence of prior diagnosis of CDI. Statistical analysis with Pearson's chi-squared and two-sample -test was performed.
The incidence of CDI among IBD patients was 6.7%. There was equal prevalence of CDI among Crohn's disease (CD) ( = 21, 49%) and ulcerative colitis (UC) ( = 22, 51%). IBD patients acquired CDI at a mean age of 42.7 years, with 56% of infections acquired in the community and only 28% associated with healthcare. Only 30% of IBD patients with CDI had prior antibiotic use, and 16% had prior steroid use. IBD patients were significantly more likely to require biologic therapy (57% versus 37%, < 0.01) and have extraintestinal manifestations of IBD (43% versus 28%, < 0.02).
IBD patients are more susceptible to CDI at a younger age and often lack traditional risk factors. IBD patients with at least one CDI were more likely to require biologic therapy and had greater rates of extraintestinal manifestations.
调查炎症性肠病(IBD)患者艰难梭菌感染(CDI)的流行病学及危险因素。
这是一项对诊断为IBD患者的回顾性研究。筛查了1006份病历,654例患者符合纳入标准。根据既往是否诊断为CDI将患者分为2组。采用Pearson卡方检验和双样本检验进行统计分析。
IBD患者中CDI的发生率为6.7%。克罗恩病(CD)(n = 21,49%)和溃疡性结肠炎(UC)(n = 22,51%)中CDI的患病率相当。IBD患者发生CDI的平均年龄为42.7岁,56%的感染发生在社区,仅28%与医疗保健相关。IBD合并CDI的患者中仅30%曾使用过抗生素,16%曾使用过类固醇。IBD患者更有可能需要生物治疗(57%对37%,P < 0.01)且有IBD肠外表现(43%对28%,P < 0.02)。
IBD患者在较年轻时更容易发生CDI,且常常缺乏传统危险因素。至少发生过一次CDI的IBD患者更有可能需要生物治疗,且肠外表现发生率更高。