Risk factors and clinical implication of superimposed Campylobacter jejuni infection in patients with underlying ulcerative colitis.
Risk factors and clinical implication of superimposed Campylobacter jejuni infection in patients with underlying ulcerative colitis.
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DOI：
10.1093/gastro/gov029
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发表时间：
2016-11
影响因子：
3.6
通讯作者：
Shen B
中科院分区：
文献类型：
--
作者：
Arora Z;Mukewar S;Wu X;Shen B
背景和目的：空肠弯曲菌重叠感染（CJI）已被描述在溃疡性结肠炎（UC）患者。其危险因素和对UC病程的影响尚不清楚。我们的目的是评估UC患者中CJI的危险因素以及细菌感染对UC结局的影响。方法：在总共918例UC患者中，21例（2.3%）患者被发现为CJI阳性（研究组）。对照组包括84名年龄匹配的UC患者，他们的CJI检测结果为阴性。比较两组间CJI诊断后1年时CJI和UC相关结局的危险因素。结果：10例（47.6%）CJI患者在诊断时需要住院，其中8例因“UC发作”而住院。抗生素治疗导致13例患者（61.9%）症状改善。在多变量分析中，发现前一年的住院是CJI的独立危险因素[比值比（OR）：3.9; 95%置信区间（CI）：1.1-14.1]，慢性肝病有成为强危险因素的趋势（OR：5.0; 95% CI：0.9-28.3）。在1年随访时，研究组中UC相关结肠切除术（28.8% vs. 14.3%; P = 0.11）和死亡率（9.5% vs. 1.2%; P = 0.096）有较高的趋势。结论：最近1年内住院与UC患者CJI风险增加相关。在合并CJI的患者中，UC的临床结局有恶化的趋势，这通常与需要住院的UC发作相关。
Background and aims: Superimposed Campylobacter jejuni infection (CJI) has been described in patients with ulcerative colitis (UC). Its risk factors and impact on the disease course of UC are not known. Our aims were to evaluate the risk factors for CJI in UC patients and the impact of the bacterial infection on outcomes of UC. Methods: Out of a total of 918 UC patients tested, 21 (2.3%) of patients were found to be positive for CJI (the study group). The control group comprised 84 age-matched UC patients who had tested negative for CJI. Risk factors for CJI and UC-related outcomes at 1 year after diagnosis of CJI were compared between the two groups. Results: Ten patients (47.6%) with CJI required hospital admission at the time of diagnosis, including eight for the management of “UC flare”. Treatment with antibiotics resulted in improvement in symptoms in 13 patients (61.9%). On multivariate analysis, hospital admission in the preceding year was found to be an independent risk factor for CJI [odds ratio (OR): 3.9; 95% confidence interval (CI): 1.1–14.1] and there was a trend for chronic liver disease as a strong risk factor (OR: 5.0; 95% CI: 0.9–28.3). At 1-year follow up, there was a trend for higher rates of UC-related colectomy (28.8% vs. 14.3%; P = 0.11), and mortality (9.5% vs. 1.2%; P = 0.096) in the study group. Conclusion: Recent hospitalization within 1 year was found to be associated with increased risk for CJI in UC patients. There was a trend for worse clinical outcomes of UC with in patients with superimposed CJI, which was frequently associated with UC flare requiring hospital admission.
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影响因子：
158.5
作者：
SCHROEDER, KW;TREMAINE, WJ;ILSTRUP, DM
通讯作者：
ILSTRUP, DM
影响因子：
29.4
作者：
Gradel, Kim O.;Nielsen, Hans L.;Nielsen, Henrik
通讯作者：
Nielsen, Henrik
影响因子：
8
作者：
Antonelli, Elisabetta;Baldoni, Monia;Bassotti, Gabrio
通讯作者：
Bassotti, Gabrio
影响因子：
3.1
作者：
BLASER, MJ;DUNCAN, DJ;WANG, WLL
通讯作者：
WANG, WLL
影响因子：
4.2
作者：
Kalischuk LD;Inglis GD;Buret AG
通讯作者：
Buret AG