Department of Gastroenterology, Peking Union Medical College Hospital, Chinese Academy of Medical Sciences, Beijing, China.
Division of Gastroenterology and Hepatology, Key Laboratory of Gastroenterology and Hepatology, Ministry of Health, Inflammatory Bowel Disease Research Center, Shanghai Institute of Digestive Disease, Renji Hospital, Shanghai Jiao Tong University Sch.
Gut Liver. 2022 Sep 15;16(5):726-735. doi: 10.5009/gnl210217. Epub 2022 May 25.
BACKGROUND/AIMS: Opportunistic infection in inflammatory bowel disease (IBD) has become a serious problem. However, its status of doctors' opinions and test equipment in hospitals are unclear. The aim of the study was to investigate these issues to improve the prognosis of IBD patients.
This retrospective, multicenter study was conducted by 83 investigators who were members of the Asian Organization for Crohn's and Colitis. Data on opportunistic infection were collected from hospital databases between January 2017 and December 2017. The survey consisted of 11 items.
Most physicians appreciated the diagnostic value of tissue cytomegalovirus (CMV) DNA, accounting for 86.1% of members in China, 37.5% in Japan, 52.9% in South Korea, and 66.7% in Southeast Asia. Only 83.1% of hospitals had the ability to test for CMV immunohistochemistry in Asia. Hepatitis B surface antigen (HBsAg) screening was recommended by all members. However, only 66.7% in China, 70.6% in South Korea, and 66.7% in Southeast Asia agreed to routinely vaccinate IBD patients when HBsAg tested negative. Most members preferred metronidazole (74.7%) as the first choice for patients with infection. However, the proportion of stool toxin test was lower in China than in other areas (75.0% in China vs 95.8% in Japan and 100% in South Korea and Southeast Asia, p<0.05).
Opportunistic infection from CMV, hepatitis B virus, and should be of high concern for IBD patients. More efforts are needed, such as understanding consensus in clinical practice and improving testing facilities in hospitals.
背景/目的：炎症性肠病（IBD）中的机会性感染已成为一个严重的问题。然而，其在医院中医生意见和检测设备的状况尚不清楚。本研究旨在调查这些问题，以改善 IBD 患者的预后。
这是一项由 83 名亚洲克罗恩病和结肠炎组织成员进行的回顾性多中心研究。2017 年 1 月至 2017 年 12 月期间，从医院数据库中收集机会性感染的数据。调查包括 11 个项目。
大多数医生认为组织巨细胞病毒（CMV）DNA 的诊断价值较高，中国的成员中有 86.1%、日本有 37.5%、韩国有 52.9%、东南亚有 66.7%。亚洲仅有 83.1%的医院有能力进行 CMV 免疫组织化学检测。所有成员均建议筛查乙型肝炎表面抗原（HBsAg）。然而，当 HBsAg 检测阴性时，仅中国的 66.7%、韩国的 70.6%和东南亚的 66.7%同意常规为 IBD 患者接种疫苗。大多数成员首选甲硝唑（74.7%）作为 感染患者的首选药物。然而，中国的粪便 毒素检测比例低于其他地区（中国为 75.0%，日本为 95.8%，韩国和东南亚为 100%，p<0.05）。
CMV、乙型肝炎病毒和 引起的机会性感染应引起 IBD 患者的高度关注。需要做出更多努力，例如了解临床实践中的共识和改善医院的检测设施。
