Risk factors for opportunistic infections in patients with inflammatory bowel disease
Risk factors for opportunistic infections in patients with inflammatory bowel disease
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DOI：
10.1053/j.gastro.2008.01.012
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发表时间：
2008-04-01
期刊：
影响因子：
29.4
通讯作者：
Egan, Laurence J.
中科院分区：
文献类型：
--
作者：
Toruner, Murat;Loftus, Edward V., Jr.;Egan, Laurence J.
背景和目的：我们试图识别和量化与炎症性肠病患者机会性感染相关的临床因素。方法：我们连续确定了 100 名患有机会性感染的 IBD 患者。对于每个病例，选择2名匹配且无机会性感染史的IBD患者作为对照。条件逻辑回归用于评估假定的危险因素与机会性感染之间的关联，以比值比 (OR) 和 95% 置信区间 (CI) 表示。结果：在单变量分析中，使用皮质类固醇（OR，3.4；95% CI，1.8-6.2）、硫唑嘌呤/6-巯基嘌呤（OR，3.1；95% CI，1.7-5.5）和英夫利昔单抗（OR，4.4；95% CI，1.2-17.1）单独与显着增加的几率相关。机会性感染。多变量分析表明，对于机会性感染，使用任何一种药物的 OR 为 2.9（95% CI，1.5-5.3），而使用其中 2 种或 3 种药物的 OR 为 14.5（95% CI，4.9-43）。 50 岁以上的 IBD 患者发生机会性感染的相对风险最大（OR，3.0。95% CI，1.2-7.2，相对于 24 岁或以下的患者）。没有患者死于机会性感染。结论：免疫抑制药物（尤其是联合使用时）和年龄较大与机会性感染风险增加相关。 IBD 患者机会性感染的绝对风险以及任何预防策略的潜在益处仍有待确定。
Background & Aims: We sought to identify and quantify the clinical factors that were associated with opportunistic infections in inflammatory bowel disease patients. Methods: We identified 100 consecutive IBD patients with opportunistic infections. For each case, 2 matched IBD patients who did not have a history of opportunistic infection were selected as controls. Conditional logistic regression was used to assess associations between putative risk factors and opportunistic infections, presented as odds ratios (OR) and 95% confidence intervals (CIs). Results: In univariate analysis, use of corticosteroids (OR, 3.4; 95% CI, 1.8-6.2), azathioprine/6-mercaptopurine (OR, 3.1; 95% CI, 1.7-5.5), and infliximab (OR, 4.4; 95% Cl, 1.2-17.1) were associated individually with significantly increased odds for opportunistic infection. Multivariate analysis indicated that use of any one of these drugs yielded an OR of 2.9 (95% CI, 1.5-5.3), whereas use of 2 or 3 of these drugs yielded an OR of 14.5 (95% Cl, 4.9-43) for opportunistic infection. The relative risk of opportunistic infection was greatest in IBD patients seen at older than 50 years of age (OR, 3.0. 95% CI, 1.2-7.2, relative to those 24 years or younger). No patient died from opportunistic infection. Conclusions: Immunosuppressive medications, especially when used in combination, and older age are associated with increased risk of opportunistic infections. The absolute risk of opportunistic infection in IBD patients remains to be determined, as does any potential benefit of any preventive strategy.