Increased Short- and Long-Term Risk of Inflammatory Bowel Disease After Salmonella or Campylobacter Gastroenteritis
Increased Short- and Long-Term Risk of Inflammatory Bowel Disease After Salmonella or Campylobacter Gastroenteritis
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DOI：
10.1053/j.gastro.2009.04.001
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发表时间：
2009-08-01
期刊：
影响因子：
29.4
通讯作者：
Nielsen, Henrik
中科院分区：
文献类型：
--
作者：
Gradel, Kim O.;Nielsen, Hans L.;Nielsen, Henrik
背景与目的：炎症性肠病的发病机制可能涉及多种共生性肠道细菌和潜在致病菌。我们比较了一组记录在案的沙门氏菌或弯曲杆菌胃肠炎患者与丹麦同一人群中年龄和性别匹配的对照组患IBD的风险。方法：从1991年到2003年，我们从丹麦北日德兰和奥胡斯县的实验室登记中确定了13,324名沙门氏菌/弯曲杆菌胃肠炎患者，并从这些县确定了26,648名未暴露的对照组。在这些患者中，176名感染前暴露的IBD患者、352名未暴露的对照组和80名感染沙门氏菌/弯曲菌之前未暴露的IBD患者被排除在外。最终的研究队列包括13,148名接触者和26,216名未接触者，他们被跟踪了长达15年(平均7.5年)。结果：107例暴露者(1.2%)和73例非暴露者(0.5%)首次被诊断为IBD。通过年龄、性别和共病校正的COX比例风险回归分析，整个期间IBD的危险比(95%可信区间)为2.9(2.2-3.9)，如果排除沙门氏菌/弯曲菌感染后的第一年，则为1.9(1.4-2.6)。在整个15年的观察期内，观察到暴露于此的受试者的风险增加。沙门氏菌(n=6463)和弯曲杆菌(n=6685)以及首次诊断为克罗恩病(n=47)和溃疡性结肠炎(n=133)的风险增加类似。结论：在我们以人群为基础的队列研究中，在实验室登记中被告知患有沙门氏菌/弯曲杆菌胃肠炎的个体，IBD的风险增加。
BACKGROUND & AIMS: Various commensal enteric and potentially pathogenic bacteria may be involved in the pathogenesis of inflammatory bowel diseases (IBD). We compared the risk of IBD between a cohort of patients with documented Salmonella or Campylobacter gastroenteritis and an age- and gender-matched control group from the same population in Denmark. METHODS: We identified 13,324 patients with Salmonellal/Campylobacter gastroenteritis from laboratory registries in North Jutland and Aarhus counties, Denmark, from 1991 through 2003, and 26,648 unexposed controls from the same counties. Of these, 176 exposed patients with IBD before the infection, their 352 unexposed controls, and 80 unexposed individuals with IBD before the Salmonella/Campylobacter infection were excluded. The final study cohort of 13,148 exposed and 26,216 unexposed individuals were followed for up to 15 years (mean, 7.5 years). RESULTS: A first-time diagnosis of IBD was reported in 107 exposed (1.2%) and 73 unexposed individuals (0.5%). By age, gender, and comorbidity adjusted Cox proportional hazards regression analysis, the hazard ratio (95% confidence interval) for IBD was 2.9 (2.2-3.9) for the whole period and 1.9 (1.4-2.6) if the first year after the Salmonella/Campylobacter infection was excluded. The increased risk in exposed subjects was observed throughout the 15-year observation period. The increased risk was similar for Salmonella (n = 6463) and Campylobacter (n = 6685) and for a first-time diagnosis of Crohn's disease (n = 47) and ulcerative colitis (n = 133). CONCLUSIONS: In our population-based cohort study with complete follow-up, an increased risk of IBD was demonstrated in individuals notified in laboratory registries with an episode of Salmonella/Campylobacter gastroenteritis.