Nested case-control study on risk factors for opportunistic infections in patients with inflammatory bowel disease

作     者：Shan-Shan Gong Yi-Hong Fan Qing-Qing Han Bin Lv Yi Xu 

作者机构：Department of GastroenterologyFirst Affiliated Hospital of Zhejiang Chinese Medical University 

出 版 物：《World Journal of Gastroenterology》 (世界胃肠病学杂志（英文版）)

年 卷 期：2019年第25卷第18期

页      面：2240-2250页

核心收录：

学科分类：10[医学] 

基　　金：National Natural Science Foundation of China,No.81473506 Natural Science Foundation of Zhejiang Province,No.LY16H290001 and No.LY17H290009 Project of Department of Construction of Zhejiang Province,No.WKJ-ZJ-1531 Zhejiang TCM Science and Technology Project,No.2016ZB047 and No.2017ZA056 

主　　题：Nested case-control study Opportunistic infections Inflammatory bowel disease 

摘      要：BACKGROUND When opportunistic infections occur, patients with inflammatory bowel disease(IBD) commonly display a significantly increased rate of morbidity and *** increasing use of immunosuppressive agents and biological agents,opportunistic infections are becoming a hot topic in the perspective of drug safety in IBD patients. Despite the well-established role of opportunistic infections in the prognosis of IBD patients, there are few epidemiological data investigating the incidence of opportunis-tic infections in IBD patients in China. Besides, the risk factors for opportunistic infection in Chinese IBD patients remain *** To predict the incidence of opportunistic infections related to IBD in China, and explore the risk factors for opportunistic *** A single-center, prospective study of IBD patients was conducted. The patients were followed for up to 12 mo to calculate the incidence of infections. For each infected IBD patient, two non-infected IBD patients were selected as controls. A conditional logistic regression analysis was used to assess associations between putative risk factors and opportunistic infections, which are represented as odds ratios(OR) and 95% confidence intervals(CIs).RESULTS Seventy(28.11%) out of 249 IBD patients developed opportunistic *** difficile infections and respiratory syncytial virus infections were found in 24 and 16 patients, respectively. In a univariate analysis, factors such as the severity of IBD, use of an immunosuppressant or immunosuppressants, high levels of fecal calprotectin, and C-reactive protein or erythrocyte sedimentation rate were individually related to a significantly increased risk of opportunistic infection. Multivariate analysis indicated that the use of any immunosuppressant yielded an OR of 3.247(95%CI: 1.128-9.341), whereas the use of any two immunosuppressants yielded an OR of 6.457(95%CI: 1.726-24.152) for opportunistic infection. Interestingly, when im