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炎症性肠病患者感染危险因素分析

Analysis of risk factors of infection in patients with inflammatory bowel disease.

作者信息

Jakubowska Alicja, Szydlarska Dorota, Rydzewska Grażyna

机构信息

National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.

Family Medicine Clinic, National Medical Institute of the Ministry of the Interior and Administration, Warsaw, Poland.

出版信息

Prz Gastroenterol. 2024;19(3):277-283. doi: 10.5114/pg.2024.143145. Epub 2024 Sep 18.

Abstract

INTRODUCTION

infection (CDI) is one of the most important challenges in contemporary gastroenterology. However, data from CDI studies are sometimes contradictory.

AIM

To analyse the risk factors for CDI in patients with inflammatory bowel disease (IBD).

MATERIAL AND METHODS

This is a retrospective analysis of the medical records of 204 patients (77 IBD with CDI, 50 with IBD without CDI, and a control group of 77) hospitalised in a referral centre in Warsaw. Data were entered and analysed by using univariate logistic regression models.

RESULTS

Patients with IBD and CDI had significantly longer hospitalisation time than patients with IBD without CDI. The population of patients with CDI and IBD was statistically significantly younger ( < 0.001). Patients with IBD and CDI had a lower body mass index ( < 0.001) and were more often treated with antibiotics ( < 0.001). Prior antibiotic use (< 1 month) was a risk factor for CDI ( = 0.003). Lower body mass index ( < 0.001) and lower levels of albumins ( = 0.036) were strong risk factors for CDI in the study group. Additional risk factors were young age ( < 0.001), length of hospitalisation ( = 0.001), treatment with glucocorticosteroids ( = 0.001), immunosuppressive treatment ( = 0.001), and gastritis and/or duodenitis ( = 0.002). The study did not confirm that proton pump inhibitors or biologic treatment affected the risk of CDI.

CONCLUSIONS

The risk factors for CDI in patients with IBD include younger age, female gender, low body mass index and hypoalbuminaemia, use of thiopurines, antibiotics, and glucocorticosteroids, prolonged hospitalisation, and gastritis and/or duodenitis.

摘要

引言

艰难梭菌感染(CDI)是当代胃肠病学面临的最重要挑战之一。然而,CDI研究的数据有时相互矛盾。

目的

分析炎症性肠病(IBD)患者发生CDI的危险因素。

材料与方法

这是一项对在华沙一家转诊中心住院的204例患者(77例IBD合并CDI、50例IBD未合并CDI以及77例对照组)的病历进行的回顾性分析。通过单因素逻辑回归模型录入和分析数据。

结果

IBD合并CDI的患者住院时间显著长于IBD未合并CDI的患者。CDI和IBD患者群体在统计学上显著更年轻(<0.001)。IBD合并CDI的患者体重指数较低(<0.001),且更常接受抗生素治疗(<0.001)。既往使用抗生素(<1个月)是发生CDI的危险因素(=0.003)。较低的体重指数(<0.001)和较低的白蛋白水平(=0.036)是研究组发生CDI的强危险因素。其他危险因素包括年轻(<0.001)、住院时间(=0.001)、糖皮质激素治疗(=0.001)、免疫抑制治疗(=0.001)以及胃炎和/或十二指肠炎(=0.002)。该研究未证实质子泵抑制剂或生物治疗会影响CDI风险。

结论

IBD患者发生CDI的危险因素包括年龄较小、女性、低体重指数和低白蛋白血症、使用硫唑嘌呤、抗生素和糖皮质激素、住院时间延长以及胃炎和/或十二指肠炎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/cf1e/11718504/8bf2a0d591a7/PG-19-54808-g001.jpg

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