Division of Internal Medicine, University of Connecticut Health Center, Farmington, Connecticut, USA.
Center on Aging, University of Connecticut Health Center, Farmington, Connecticut, USA.
Inflamm Bowel Dis. 2019 Nov 14;25(12):1966-1973. doi: 10.1093/ibd/izz093.
Inflammatory bowel disease (IBD) entails a higher risk of infections, including those that could be prevented with immunizations. Current Advisory Committee on Immunization Practices and American College of Gastroenterology vaccine recommendations for patients with IBD are based on low levels of evidence.
We conducted a population-based descriptive cohort study using the US National Inpatient Sample ICD-9 codes from 2012 to 2015. We measured the frequency of patients with IBD who were admitted to the hospital with a vaccine-preventable disease (VPD). Frequencies and demographics were determined and compared between patients with IBD and patients without IBD.
Of discharges, 596,485 (2.08%) were secondary to a VPD, and 7180 (1.2%) were found to have both a VPD and IBD (including Crohn disease and ulcerative colitis). The most common VPDs among patients with IBD were herpes zoster virus (HZV) (34.9%) and hepatitis B virus (31.6%), followed by influenza (22.1%). Pneumococcal pneumonia (9.1%) and hepatitis A virus (2.4%) were less common. Inpatients with IBD were twice as likely to have HZV when compared to non-IBD inpatients (odds ratios [OR] = 2.30 [95% CI, 2.06-2.58], P < 0.0001) This finding was consistent for every study year. Pneumococcal pneumonia [OR = 0.62 (95% CI, 0.52-0.74), P < 0.0001] and influenza [OR = 0.72 (95% CI, 0.63-0.81), P < 0.0001] were significantly lower in the IBD population. There was no difference for other VPDs.
HZV was the most frequent VPD in IBD inpatients. Patients with IBD have a higher rate of hospital admissions with HZV and a lower rate of pneumococcal pneumonia and influenza admissions when compared with non-IBD patients. For other VPDs, patients with IBD have the same rate of admission as the general population.
炎症性肠病（IBD）会增加感染的风险，包括可以通过疫苗预防的感染。目前，免疫实践咨询委员会和美国胃肠病学会针对 IBD 患者的疫苗推荐是基于低水平的证据。
我们使用 2012 年至 2015 年美国国家住院患者样本 ICD-9 代码进行了一项基于人群的描述性队列研究。我们测量了患有 IBD 并因疫苗可预防疾病（VPD）住院的患者的频率。确定了 IBD 患者和非 IBD 患者之间的频率和人口统计学差异，并进行了比较。
在出院患者中，596485 例（2.08%）是由 VPD 引起的，其中 7180 例（1.2%）被发现同时患有 VPD 和 IBD（包括克罗恩病和溃疡性结肠炎）。IBD 患者中最常见的 VPD 是带状疱疹病毒（HZV）（34.9%）和乙型肝炎病毒（31.6%），其次是流感（22.1%）。肺炎球菌肺炎（9.1%）和甲型肝炎病毒（2.4%）较少见。与非 IBD 住院患者相比，IBD 住院患者患 HZV 的可能性是其两倍（比值比[OR] = 2.30 [95%CI，2.06-2.58]，P < 0.0001），这一发现与每个研究年度都一致。肺炎球菌肺炎[OR = 0.62（95%CI，0.52-0.74），P < 0.0001]和流感[OR = 0.72（95%CI，0.63-0.81），P < 0.0001]在 IBD 人群中显著较低。其他 VPD 则没有差异。
HZV 是 IBD 住院患者中最常见的 VPD。与非 IBD 患者相比，IBD 患者因 HZV 住院的比例较高，而因肺炎球菌肺炎和流感住院的比例较低。对于其他 VPD，IBD 患者的住院率与普通人群相同。
