Idan Goren1, Adi Brom2, Henit Yanai1, Amir Dagan3, Gad Segal2, Ariel Israel4. 1. Division of Gastroenterology, Rabin Medical Center * , Petah Tikva, Israel. 2. Internal Medicine T, Chaim Sheba Medical Center * , Tel-Hashomer, Ramat-Gan, Israel. 3. Rheumatology Unit, Assuta Medical Center, Ashdod, Israel. 4. Clalit Jerusalem Research Center, Clalit Health Services, Jerusalem, Israel.
Abstract
BACKGROUND: Patients with inflammatory bowel disease might be at increased risk of invasive bacterial infections. OBJECTIVES: The objective of this study was to identify the rate of bacteremia in hospitalised patients with inflammatory bowel disease and risk factors. METHODS: An observational cohort of hospitalised patients with inflammatory bowel disease, aged 16-80 years, from 2008 to 2017 in a large tertiary hospital. Patients with Charlson comorbidity index of 2 or greater were excluded. Patients with one or more positive blood culture were reviewed. Logistic regression was used to evaluate risk factors for bacteremia. RESULTS: Of 5522 admitted patients, only 1.3% had bacteremia (73/5522) (39, Crohn's disease; 25, ulcerative colitis; nine, unclassified inflammatory bowel disease). The most common pathogen was Escherichia coli (19/73 patients). The mortality rate at 30 days of patients with bacteremia was 13.7% (10/73). Longer hospitalisations (mean length of stay (21.6 ± 31.0 vs. 6.4 ± 16.0 days; P < 0.0001) and older age (mean age 47.5 ± 18.0 vs. 40.2 ± 15.4 years, P < 0.0001)) were associated with an increased risk of bacteremia. In multivariate analysis, treatment with either anti-tumour necrosis factor α, purine analogues, steroids or amino salicylates was not associated with an increased risk of bacteremia. Risk was greatest among patients aged 65 years or older (relative risk 2.84, 95% confidence interval 1.6-4.8; P = 0.0001) relative to those under 65 years. CONCLUSION: Age over 65 years, but not inflammatory bowel disease-related medications, is associated with an increased risk of bacteremia in hospitalised patients with inflammatory bowel disease.
BACKGROUND:Patients with inflammatory bowel disease might be at increased risk of invasive bacterial infections. OBJECTIVES: The objective of this study was to identify the rate of bacteremia in hospitalised patients with inflammatory bowel disease and risk factors. METHODS: An observational cohort of hospitalised patients with inflammatory bowel disease, aged 16-80 years, from 2008 to 2017 in a large tertiary hospital. Patients with Charlson comorbidity index of 2 or greater were excluded. Patients with one or more positive blood culture were reviewed. Logistic regression was used to evaluate risk factors for bacteremia. RESULTS: Of 5522 admitted patients, only 1.3% had bacteremia (73/5522) (39, Crohn's disease; 25, ulcerative colitis; nine, unclassified inflammatory bowel disease). The most common pathogen was Escherichia coli (19/73 patients). The mortality rate at 30 days of patients with bacteremia was 13.7% (10/73). Longer hospitalisations (mean length of stay (21.6 ± 31.0 vs. 6.4 ± 16.0 days; P < 0.0001) and older age (mean age 47.5 ± 18.0 vs. 40.2 ± 15.4 years, P < 0.0001)) were associated with an increased risk of bacteremia. In multivariate analysis, treatment with either anti-tumour necrosis factor α, purine analogues, steroids or amino salicylates was not associated with an increased risk of bacteremia. Risk was greatest among patients aged 65 years or older (relative risk 2.84, 95% confidence interval 1.6-4.8; P = 0.0001) relative to those under 65 years. CONCLUSION: Age over 65 years, but not inflammatory bowel disease-related medications, is associated with an increased risk of bacteremia in hospitalised patients with inflammatory bowel disease.
Authors: Randi Marie Mohus; Julie Paulsen; Lise Gustad; Åsa Askim; Arne Mehl; Andrew T DeWan; Jan Egil Afset; Bjørn Olav Åsvold; Erik Solligård; Jan Kristian Damås Journal: Intensive Care Med Date: 2018-07-23 Impact factor: 17.440
Authors: K R Gardiner; M I Halliday; G R Barclay; L Milne; D Brown; S Stephens; R J Maxwell; B J Rowlands Journal: Gut Date: 1995-06 Impact factor: 23.059
Authors: M Delgado-Rodríguez; A Bueno-Cavanillas; R López-Gigosos; J de Dios Luna-Castillo; J Guillén-Solvas; O Moreno-Abril; B Rodríguez-Tuñas; A Cueto-Espinar; R Rodríguez-Contreras; R Gálvez-Vargas Journal: Eur J Epidemiol Date: 1990-03 Impact factor: 8.082